How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,311Professionalmedian $550 · 10th to 90th $398 to $813
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 $457.09 Median $457.09 Typical High $588.84 | Professional | None | $457.09 | $457.09 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $660.69 | Professional | None | $331.13 | $489.78 | $660.69 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $741.31 Typical High $977.24 | Professional | 50 · Both sides | $489.78 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,691.53 | Facility | None | $707.95 | $1,862.09 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $851.14 | Professional | None | $478.63 | $616.60 | $851.14 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $616.60 Typical High $831.76 | Professional | None | $407.38 | $616.60 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $588.84 | Professional | None | $457.09 | $457.09 | $588.84 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $851.14 | Professional | None | $467.74 | $616.60 | $851.14 |
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 $229.09 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $346.74 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $416.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $295.12 | Professional | 52 · Reduced service | $229.09 | $229.09 | $295.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $117.49 | Professional | 53 · Discontinued | $91.20 | $91.20 | $117.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $346.74 Typical High $446.68 | Professional | 54 · Surgery only | $346.74 | $346.74 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $89.13 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $58.88 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $58.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $323.59 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $323.59 | $323.59 | $416.87 |
Where Maine sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 30th of 51
$562
AK $1,698UT $347
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.