How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $1,820Professionalmedian $257 · 10th to 90th $170 to $427
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 $169.82 Median $218.78 Typical High $269.15 | Professional | None | $169.82 | $218.78 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $426.58 | Professional | None | $169.82 | $257.04 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $2,041.74 | Facility | None | $537.03 | $1,412.54 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $436.52 | Professional | None | $234.42 | $309.03 | $436.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $426.58 | Professional | None | $186.21 | $288.40 | $426.58 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $263.03 | Professional | None | $169.82 | $218.78 | $263.03 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $389.05 | Professional | None | $218.78 | $295.12 | $389.05 |
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 $85.11 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $85.11 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $33.88 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 54 · Surgery only | $128.82 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $33.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | 78 · Unplanned return to OR | $120.23 | $154.88 | $154.88 |
Where Maine sits
The same service costs 4.6 times more in Alaska 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· 34th of 51
$257
AK $912UT $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.