How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $891 · 10th to 90th $437 to $2,239
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 $436.52 Median $707.95 Typical High $1,995.26 | Professional | None | $436.52 | $707.95 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,000.00 Typical High $2,238.72 | Professional | None | $371.54 | $1,000.00 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $575.44 Median $1,513.56 Typical High $3,311.31 | Professional | 50 · Both sides | $575.44 | $1,513.56 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $2,951.21 | Facility | None | $812.83 | $2,187.76 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $831.76 Typical High $2,290.87 | Professional | None | $512.86 | $831.76 | $2,290.87 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $2,454.71 | Professional | None | $512.86 | $741.31 | $2,454.71 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,995.26 | Professional | None | $436.52 | $707.95 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $512.86 Median $741.31 Typical High $2,238.72 | Professional | None | $512.86 | $741.31 | $2,238.72 |
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 $288.40 Median $288.40 Typical High $1,000.00 | Professional | 52 · Reduced service | $288.40 | $288.40 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $398.11 | Professional | 53 · Discontinued | $114.82 | $114.82 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $1,513.56 | Professional | 54 · Surgery only | $426.58 | $426.58 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $302.00 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $199.53 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,412.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $288.40 Median $288.40 Typical High $1,000.00 | Professional | 52 · Reduced service | $288.40 | $288.40 | $1,000.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $398.11 | Professional | 53 · Discontinued | $114.82 | $114.82 | $398.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $1,513.56 | Professional | 54 · Surgery only | $426.58 | $426.58 | $1,513.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $302.00 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $302.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $199.53 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $199.53 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $398.11 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $398.11 | $398.11 | $1,412.54 |
Where Maine sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 48th of 51
$1,000
AK $3,020NE $692
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.