How much rates vary
Facilitymedian $1,072 · 10th to 90th $229 to $3,311Professionalmedian $372 · 10th to 90th $229 to $646
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 Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $426.58 | Facility | None | $229.09 | $363.08 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $562.34 | Professional | None | $229.09 | $363.08 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $645.65 | Professional | None | $223.87 | $371.54 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,348.96 Typical High $1,862.09 | Facility | None | $707.95 | $1,348.96 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $467.74 Typical High $660.69 | Professional | None | $309.03 | $467.74 | $660.69 |
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 $269.15 Median $426.58 Typical High $660.69 | Professional | None | $269.15 | $426.58 | $660.69 |
Martin's Point Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $48,977.88 | Facility | None | $229.09 | $363.08 | $48,977.88 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $363.08 Typical High $562.34 | Professional | None | $229.09 | $363.08 | $562.34 |
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 $295.12 Median $467.74 Typical High $645.65 | Professional | None | $295.12 | $467.74 | $645.65 |
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 $114.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $114.82 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $45.71 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $169.82 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $33.88 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $22.91 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $251.19 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $158.49 | $251.19 | $251.19 |
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· 39th of 51
$380
AK $1,259UT $275
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.