How much rates vary
Facilitymedian $501 · 10th to 90th $145 to $708Professionalmedian $182 · 10th to 90th $117 to $309
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Professional | None | $117.49 | $165.96 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $158.49 Typical High $213.80 | Professional | None | $102.33 | $158.49 | $213.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $239.88 Typical High $316.23 | Professional | 50 · Both sides | $154.88 | $239.88 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $208.93 Typical High $707.95 | Facility | None | $56.23 | $208.93 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $354.81 | Professional | None | $144.54 | $245.47 | $354.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $354.81 | Professional | None | $125.89 | $208.93 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Professional | None | $117.49 | $165.96 | $223.87 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $138.04 Median $204.17 Typical High $316.23 | Professional | None | $138.04 | $204.17 | $316.23 |
12 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $67.61 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $67.61 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $26.92 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $93.33 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $93.33 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $67.61 Typical High $112.20 | Professional | 52 · Reduced service | $66.07 | $67.61 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $44.67 | Professional | 53 · Discontinued | $26.30 | $26.92 | $44.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $169.82 | Professional | 54 · Surgery only | $97.72 | $100.00 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $33.88 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $22.39 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $93.33 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $91.20 | $93.33 | $158.49 |
Where Maine sits
The same service costs 4.5 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Maine· 32nd of 51
$186
AK $457KY $102
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.