How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,311Professionalmedian $490 · 10th to 90th $347 to $759
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 $338.84 Median $371.54 Typical High $489.78 | Professional | None | $338.84 | $371.54 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $457.09 Typical High $758.58 | Professional | None | $295.12 | $457.09 | $758.58 |
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 $398.11 Median $537.03 Typical High $776.25 | Professional | None | $398.11 | $537.03 | $776.25 |
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 $346.74 Median $537.03 Typical High $776.25 | Professional | None | $346.74 | $537.03 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $489.78 | Professional | None | $338.84 | $371.54 | $489.78 |
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 $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
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 $186.21 Median $186.21 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $186.21 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $281.84 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $186.21 Typical High $245.47 | Professional | 52 · Reduced service | $186.21 | $186.21 | $245.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $97.72 | Professional | 53 · Discontinued | $74.13 | $74.13 | $97.72 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $363.08 | Professional | 54 · Surgery only | $281.84 | $281.84 | $363.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $72.44 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $48.98 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $48.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $263.03 | $263.03 | $338.84 |
Where Maine sits
The same service costs 5.2 times more in Alabama than in Montana. 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.
Physician feeFacility fee
AL $5,469MT $1,054
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.