How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $5,754Professionalmedian $1,820 · 10th to 90th $1,318 to $2,818
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 $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $2,818.38 | Professional | None | $1,148.15 | $1,737.80 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,949.84 | $2,818.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,318.26 | $1,995.26 | $2,818.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,479.11 | $2,041.74 | $2,691.53 |
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 $724.44 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $295.12 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,230.27 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $724.44 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $724.44 | $891.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $295.12 Typical High $354.81 | Professional | 53 · Discontinued | $295.12 | $295.12 | $354.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,096.48 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,096.48 | $1,096.48 | $1,318.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $263.03 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $263.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $177.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,023.29 | $1,230.27 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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
AK $12,311KY $3,892
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.