How much rates vary
Facilitymedian $1,698 · 10th to 90th $120 to $2,570Professionalmedian $240 · 10th to 90th $186 to $363
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 $213.80 Median $239.88 Typical High $288.40 | Professional | None | $213.80 | $239.88 | $288.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $363.08 | Professional | None | $158.49 | $239.88 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $229.09 Typical High $2,290.87 | Facility | None | $102.33 | $229.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $398.11 | Professional | None | $223.87 | $257.04 | $398.11 |
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 $186.21 Median $257.04 Typical High $363.08 | Professional | None | $186.21 | $257.04 | $363.08 |
Martin's Point Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $288.40 | Professional | None | $213.80 | $239.88 | $288.40 |
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 $190.55 Median $257.04 Typical High $363.08 | Professional | None | $190.55 | $257.04 | $363.08 |
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 $104.71 Median $117.49 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $46.77 Typical High $47.86 | Professional | 53 · Discontinued | $42.66 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $173.78 Typical High $177.83 | Professional | 54 · Surgery only | $158.49 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $34.67 Typical High $35.48 | Professional | 55 · Aftercare only | $31.62 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $23.44 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.38 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $162.18 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $147.91 | $162.18 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $104.71 | $120.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $42.66 Typical High $47.86 | Professional | 53 · Discontinued | $42.66 | $42.66 | $47.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $158.49 | $158.49 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $35.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $21.38 Typical High $23.99 | Professional | 56 · Pre-op care only | $21.38 | $21.38 | $23.99 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $165.96 |
Where Maine sits
The same service costs 4.9 times more in Oklahoma than in Florida. 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· 31st of 51
$240
OK $891FL $182
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.