How much rates vary
Facilitymedian $2,344 · 10th to 90th $708 to $3,631Professionalmedian $1,072 · 10th to 90th $437 to $2,630
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 $478.63 Median $891.25 Typical High $1,949.84 | Professional | None | $478.63 | $891.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $1,047.13 Typical High $2,511.89 | Professional | None | $371.54 | $1,047.13 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,290.87 | Facility | None | $707.95 | $1,584.89 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $1,000.00 Typical High $3,019.95 | Professional | None | $512.86 | $1,000.00 | $3,019.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $512.86 Median $1,412.54 Typical High $2,818.38 | Professional | None | $512.86 | $1,412.54 | $2,818.38 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $891.25 Typical High $1,949.84 | Professional | None | $478.63 | $891.25 | $1,949.84 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $630.96 Median $1,148.15 Typical High $3,162.28 | Professional | None | $630.96 | $1,148.15 | $3,162.28 |
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 $239.88 Median $446.68 Typical High $977.24 | Professional | 52 · Reduced service | $239.88 | $446.68 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $177.83 Typical High $389.05 | Professional | 53 · Discontinued | $95.50 | $177.83 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $676.08 Typical High $1,445.44 | Professional | 54 · Surgery only | $363.08 | $676.08 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $134.90 Typical High $295.12 | Professional | 55 · Aftercare only | $72.44 | $134.90 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $89.13 Typical High $194.98 | Professional | 56 · Pre-op care only | $47.86 | $89.13 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $630.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $338.84 | $630.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $446.68 Typical High $977.24 | Professional | 52 · Reduced service | $239.88 | $446.68 | $977.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $177.83 Typical High $389.05 | Professional | 53 · Discontinued | $95.50 | $177.83 | $389.05 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $676.08 Typical High $1,445.44 | Professional | 54 · Surgery only | $363.08 | $676.08 | $1,445.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $134.90 Typical High $295.12 | Professional | 55 · Aftercare only | $72.44 | $134.90 | $295.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $89.13 Typical High $194.98 | Professional | 56 · Pre-op care only | $47.86 | $89.13 | $194.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $630.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $338.84 | $630.96 | $1,348.96 |
Where Maine sits
The same service costs 4.9 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· 45th of 51
$1,230
AK $3,020TX $617
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.