How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $1,585Professionalmedian $347 · 10th to 90th $234 to $513
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 $245.47 Median $316.23 Typical High $380.19 | Professional | None | $245.47 | $316.23 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $512.86 | Professional | None | $199.53 | $309.03 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,412.54 | Facility | None | $537.03 | $891.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $524.81 | Professional | None | $263.03 | $363.08 | $524.81 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $251.19 Median $363.08 Typical High $537.03 | Professional | None | $251.19 | $363.08 | $537.03 |
Martin's Point Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $380.19 | Professional | None | $245.47 | $316.23 | $380.19 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $537.03 | Professional | None | $288.40 | $416.87 | $537.03 |
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 $128.82 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $51.29 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $194.98 | $194.98 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $239.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $128.82 Typical High $169.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $69.18 | Professional | 53 · Discontinued | $51.29 | $51.29 | $69.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $194.98 Typical High $257.04 | Professional | 54 · Surgery only | $194.98 | $194.98 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $51.29 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $34.67 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $181.97 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $181.97 | $181.97 | $239.88 |
Where Maine sits
The same service costs 4.3 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
$347
AK $1,000UT $234
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.