How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $3,311Professionalmedian $275 · 10th to 90th $209 to $407
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 $234.42 Median $269.15 Typical High $331.13 | Professional | None | $234.42 | $269.15 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $269.15 Typical High $407.38 | Professional | None | $173.78 | $269.15 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $3,090.30 | Facility | None | $707.95 | $1,905.46 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $426.58 | Professional | None | $251.19 | $288.40 | $426.58 |
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 $208.93 Median $295.12 Typical High $426.58 | Professional | None | $208.93 | $295.12 | $426.58 |
Martin's Point Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $331.13 | Professional | None | $234.42 | $269.15 | $331.13 |
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 $218.78 Median $295.12 Typical High $407.38 | Professional | None | $218.78 | $295.12 | $407.38 |
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 $117.49 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $46.77 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $199.53 Typical High $199.53 | Professional | 54 · Surgery only | $177.83 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.44 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $165.96 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $117.49 | $117.49 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $53.70 | Professional | 53 · Discontinued | $46.77 | $46.77 | $53.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $177.83 Typical High $199.53 | Professional | 54 · Surgery only | $177.83 | $177.83 | $199.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $35.48 Typical High $39.81 | Professional | 55 · Aftercare only | $35.48 | $35.48 | $39.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $26.92 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $26.92 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $165.96 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $165.96 | $165.96 | $186.21 |
Where Maine sits
The same service costs 5.9 times more in Oklahoma 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· 32nd of 51
$275
OK $1,175UT $200
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.