How much rates vary
Facilitymedian $525 · 10th to 90th $339 to $776Professionalmedian $295 · 10th to 90th $200 to $447
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 $309.03 | Professional | None | $213.80 | $239.88 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $489.78 | Professional | None | $190.55 | $295.12 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $1,412.54 | Facility | None | $338.84 | $537.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $501.19 | Professional | None | $229.09 | $338.84 | $501.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $501.19 | Professional | None | $199.53 | $316.23 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $309.03 | Professional | None | $213.80 | $239.88 | $309.03 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $457.09 | Professional | None | $177.83 | $269.15 | $457.09 |
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 $104.71 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $42.66 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $181.97 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $218.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $104.71 | $120.23 | $154.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $42.66 | $48.98 | $61.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $181.97 Typical High $234.42 | Professional | 54 · Surgery only | $158.49 | $181.97 | $234.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $31.62 | $36.31 | $46.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $21.38 | $24.55 | $30.90 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $169.82 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $147.91 | $169.82 | $218.78 |
Where Maine sits
The same service costs 4.2 times more in Alaska than in Texas. 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· 22nd of 51
$295
AK $741TX $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.