How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,000 to $3,311Professionalmedian $316 · 10th to 90th $245 to $479
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 $257.04 Median $288.40 Typical High $309.03 | Professional | None | $257.04 | $288.40 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $489.78 | Professional | None | $245.47 | $331.13 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $1,995.26 Typical High $2,818.38 | Facility | None | $1,000.00 | $1,995.26 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $562.34 | Professional | None | $281.84 | $323.59 | $562.34 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $457.09 | Professional | None | $245.47 | $316.23 | $457.09 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $295.12 | Professional | None | $257.04 | $288.40 | $295.12 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $501.19 | Professional | None | $234.42 | $331.13 | $501.19 |
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 $128.82 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $51.29 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.70 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $181.97 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $141.25 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $141.25 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $56.23 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $28.18 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $204.17 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $194.98 | $204.17 | $204.17 |
Where Maine sits
The same service costs 6.0 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
$316
AK $1,000UT $166
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.