How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,000 to $5,754Professionalmedian $1,047 · 10th to 90th $794 to $1,585
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 $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | None | $870.96 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,621.81 | Professional | None | $794.33 | $1,096.48 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,778.28 | Professional | None | $851.14 | $1,071.52 | $1,778.28 |
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 $831.76 Median $1,071.52 Typical High $1,548.82 | Professional | None | $831.76 | $1,071.52 | $1,548.82 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $1,000.00 Typical High $1,000.00 | Professional | None | $977.24 | $1,000.00 | $1,000.00 |
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 $794.33 Median $1,148.15 Typical High $1,659.59 | Professional | None | $794.33 | $1,148.15 | $1,659.59 |
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 $436.52 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $173.78 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $645.65 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $128.82 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $87.10 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $602.56 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $489.78 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $724.44 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $144.54 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $97.72 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $676.08 | $691.83 | $691.83 |
Where Maine sits
The same service costs 6.5 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· 25th of 51
$1,072
AK $3,311TX $513
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.