How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,311Professionalmedian $457 · 10th to 90th $331 to $708
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 $346.74 Median $446.68 Typical High $524.81 | Professional | None | $346.74 | $446.68 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $707.95 | Professional | None | $275.42 | $426.58 | $707.95 |
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 $371.54 Median $501.19 Typical High $724.44 | Professional | None | $371.54 | $501.19 | $724.44 |
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 $331.13 Median $501.19 Typical High $724.44 | Professional | None | $331.13 | $501.19 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $524.81 | Professional | None | $338.84 | $436.52 | $524.81 |
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 $389.05 Median $524.81 Typical High $691.83 | Professional | None | $389.05 | $524.81 | $691.83 |
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 $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $70.79 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $269.15 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $323.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $177.83 Typical High $229.09 | Professional | 52 · Reduced service | $177.83 | $177.83 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $93.33 | Professional | 53 · Discontinued | $70.79 | $70.79 | $93.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $269.15 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $269.15 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $53.70 Typical High $69.18 | Professional | 55 · Aftercare only | $53.70 | $53.70 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $45.71 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $45.71 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $251.19 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $251.19 | $323.59 |
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· 31st of 51
$457
AK $1,479UT $302
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.