How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $1,175 · 10th to 90th $380 to $2,512
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 $501.19 Median $501.19 Typical High $2,290.87 | Professional | None | $501.19 | $501.19 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $1,202.26 Typical High $2,570.40 | Professional | None | $323.59 | $1,202.26 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $501.19 Median $1,778.28 Typical High $3,890.45 | Professional | 50 · Both sides | $501.19 | $1,778.28 | $3,890.45 |
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 $446.68 Median $724.44 Typical High $2,691.53 | Professional | None | $446.68 | $724.44 | $2,691.53 |
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 $416.87 Median $645.65 Typical High $2,884.03 | Professional | None | $416.87 | $645.65 | $2,884.03 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $2,290.87 | Professional | None | $501.19 | $501.19 | $2,290.87 |
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 $426.58 Median $645.65 Typical High $2,238.72 | Professional | None | $426.58 | $645.65 | $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 $251.19 Median $251.19 Typical High $1,148.15 | Professional | 52 · Reduced service | $251.19 | $251.19 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $457.09 | Professional | 53 · Discontinued | $100.00 | $100.00 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $338.84 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $229.09 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,584.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $1,148.15 | Professional | 52 · Reduced service | $251.19 | $251.19 | $1,148.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $457.09 | Professional | 53 · Discontinued | $100.00 | $100.00 | $457.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $1,698.24 | Professional | 54 · Surgery only | $371.54 | $371.54 | $1,698.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $338.84 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $338.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $229.09 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $229.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $1,584.89 |
Where Maine sits
The same service costs 5.8 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· 46th of 51
$1,202
AK $3,548NE $617
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.