How much rates vary
Facilitymedian $708 · 10th to 90th $398 to $1,202Professionalmedian $316 · 10th to 90th $186 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 $194.98 Median $251.19 Typical High $389.05 | Professional | None | $194.98 | $251.19 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $562.34 | Professional | None | $199.53 | $354.81 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $691.83 Typical High $2,290.87 | Facility | None | $338.84 | $691.83 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $588.84 | Professional | None | $251.19 | $389.05 | $588.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $309.03 Typical High $676.08 | Professional | None | $177.83 | $309.03 | $676.08 |
Martin's Point Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $389.05 | Professional | None | $213.80 | $275.42 | $389.05 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $512.86 | Professional | None | $169.82 | $269.15 | $512.86 |
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 $100.00 Median $112.20 Typical High $181.97 | Professional | 52 · Reduced service | $100.00 | $112.20 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $44.67 Typical High $72.44 | Professional | 53 · Discontinued | $39.81 | $44.67 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $151.36 | $165.96 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $33.88 Typical High $54.95 | Professional | 55 · Aftercare only | $30.20 | $33.88 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $22.39 Typical High $36.31 | Professional | 56 · Pre-op care only | $19.95 | $22.39 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $154.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $141.25 | $154.88 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $112.20 Typical High $181.97 | Professional | 52 · Reduced service | $109.65 | $112.20 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $44.67 Typical High $72.44 | Professional | 53 · Discontinued | $43.65 | $44.67 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $165.96 Typical High $275.42 | Professional | 54 · Surgery only | $165.96 | $165.96 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $54.95 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $22.39 Typical High $36.31 | Professional | 56 · Pre-op care only | $21.88 | $22.39 | $36.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $154.88 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $154.88 | $154.88 | $257.04 |
Where Maine sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 19th of 51
$324
AK $741KY $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.