How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $3,090Professionalmedian $263 · 10th to 90th $182 to $457
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 $181.97 Median $186.21 Typical High $223.87 | Professional | None | $181.97 | $186.21 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $263.03 Typical High $467.74 | Professional | None | $173.78 | $263.03 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $3,090.30 | Facility | None | $537.03 | $1,412.54 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $346.74 Typical High $467.74 | Professional | None | $239.88 | $346.74 | $467.74 |
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 $204.17 Median $302.00 Typical High $457.09 | Professional | None | $204.17 | $302.00 | $457.09 |
Martin's Point Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $223.87 | Professional | None | $181.97 | $186.21 | $223.87 |
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 $213.80 Median $281.84 Typical High $416.87 | Professional | None | $213.80 | $281.84 | $416.87 |
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 $91.20 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 54 · Surgery only | $138.04 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $91.20 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $93.33 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $37.15 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $37.15 | $44.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $169.82 | Professional | 54 · Surgery only | $138.04 | $138.04 | $169.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $18.62 | $22.39 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $128.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $128.82 | $128.82 | $158.49 |
Where Maine sits
The same service costs 4.4 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· 31st of 51
$269
AK $871UT $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.