How much rates vary
Facilitymedian $1,202 · 10th to 90th $363 to $1,413Professionalmedian $331 · 10th to 90th $214 to $537
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 $213.80 Median $239.88 Typical High $363.08 | Professional | None | $213.80 | $239.88 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $549.54 | Professional | None | $218.78 | $331.13 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $489.78 Typical High $1,412.54 | Facility | None | $309.03 | $489.78 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $588.84 | Professional | None | $251.19 | $380.19 | $588.84 |
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 $223.87 Median $354.81 Typical High $616.60 | Professional | None | $223.87 | $354.81 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $363.08 | Professional | None | $229.09 | $239.88 | $363.08 |
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 $194.98 Median $302.00 Typical High $512.86 | Professional | None | $194.98 | $302.00 | $512.86 |
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 $107.15 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $107.15 | $128.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $42.66 | $51.29 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $162.18 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $32.36 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.38 | $25.70 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $177.83 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $151.36 | $177.83 | $251.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $128.82 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $128.82 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $51.29 Typical High $72.44 | Professional | 53 · Discontinued | $46.77 | $51.29 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $173.78 | $190.55 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $53.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $36.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $177.83 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $162.18 | $177.83 | $251.19 |
Where Maine sits
The same service costs 4.5 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.
Maine· 21st of 51
$331
AK $794KY $178
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.