How much rates vary
Facilitymedian $1,778 · 10th to 90th $708 to $3,311Professionalmedian $741 · 10th to 90th $562 to $1,096
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 $588.84 Median $676.08 Typical High $676.08 | Professional | None | $588.84 | $676.08 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,174.90 | Professional | None | $562.34 | $776.25 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,570.40 | Facility | None | $707.95 | $1,862.09 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,258.93 | Professional | None | $602.56 | $831.76 | $1,258.93 |
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 $562.34 Median $741.31 Typical High $1,122.02 | Professional | None | $562.34 | $741.31 | $1,122.02 |
Martin's Point Setting Professional Modifier None Typical Low $602.56 Median $676.08 Typical High $676.08 | Professional | None | $602.56 | $676.08 | $676.08 |
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 $524.81 Median $741.31 Typical High $1,122.02 | Professional | None | $524.81 | $741.31 | $1,122.02 |
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 $288.40 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $288.40 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $436.52 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $407.38 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $302.00 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $89.13 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $478.63 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $478.63 | $478.63 |
Where Maine sits
The same service costs 5.5 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· 23rd of 51
$741
AK $2,344TX $427
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.