How much rates vary
Facilitymedian $2,344 · 10th to 90th $537 to $3,631Professionalmedian $501 · 10th to 90th $331 to $832
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 $389.05 Typical High $549.54 | Professional | None | $338.84 | $389.05 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $891.25 | Professional | None | $316.23 | $501.19 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $707.95 Typical High $2,290.87 | Facility | None | $457.09 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $812.83 | Professional | None | $380.19 | $588.84 | $812.83 |
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 $331.13 Median $512.86 Typical High $977.24 | Professional | None | $331.13 | $512.86 | $977.24 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $549.54 | Professional | None | $363.08 | $389.05 | $549.54 |
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 $302.00 Median $457.09 Typical High $758.58 | Professional | None | $302.00 | $457.09 | $758.58 |
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 $173.78 Median $194.98 Typical High $269.15 | Professional | 52 · Reduced service | $173.78 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $69.18 | $77.62 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $407.38 | Professional | 54 · Surgery only | $257.04 | $288.40 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $58.88 Typical High $81.28 | Professional | 55 · Aftercare only | $51.29 | $58.88 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $34.67 | $38.90 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $269.15 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $239.88 | $269.15 | $380.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $194.98 Typical High $269.15 | Professional | 52 · Reduced service | $177.83 | $194.98 | $269.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $77.62 Typical High $109.65 | Professional | 53 · Discontinued | $72.44 | $77.62 | $109.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $288.40 Typical High $407.38 | Professional | 54 · Surgery only | $269.15 | $288.40 | $407.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $58.88 Typical High $81.28 | Professional | 55 · Aftercare only | $53.70 | $58.88 | $81.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $38.90 Typical High $54.95 | Professional | 56 · Pre-op care only | $36.31 | $38.90 | $54.95 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $269.15 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $251.19 | $269.15 | $380.19 |
Where Maine sits
The same service costs 4.3 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
$501
AK $1,259KY $295
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.