How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $1,698Professionalmedian $347 · 10th to 90th $251 to $562
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 $269.15 Median $331.13 Typical High $407.38 | Professional | None | $269.15 | $331.13 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $346.74 Typical High $575.44 | Professional | None | $229.09 | $346.74 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $891.25 Typical High $1,862.09 | Facility | None | $707.95 | $891.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $588.84 | Professional | None | $281.84 | $398.11 | $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 $251.19 Median $380.19 Typical High $588.84 | Professional | None | $251.19 | $380.19 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $398.11 | Professional | None | $269.15 | $331.13 | $398.11 |
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 $229.09 Median $338.84 Typical High $524.81 | Professional | None | $229.09 | $338.84 | $524.81 |
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 $134.90 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $134.90 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $53.70 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $199.53 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $186.21 | $204.17 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $134.90 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $134.90 | $147.91 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $58.88 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $204.17 | $218.78 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $40.74 | $43.65 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $36.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $190.55 | $204.17 | $257.04 |
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· 25th of 51
$347
AK $933UT $219
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.