How much rates vary
Facilitymedian $1,698 · 10th to 90th $123 to $2,570Professionalmedian $178 · 10th to 90th $115 to $309
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 $114.82 Median $151.36 Typical High $199.53 | Professional | None | $114.82 | $151.36 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $309.03 | Professional | None | $109.65 | $177.83 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $234.42 Typical High $2,290.87 | Facility | None | $104.71 | $234.42 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $218.78 Typical High $316.23 | Professional | None | $154.88 | $218.78 | $316.23 |
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 $128.82 Median $194.98 Typical High $309.03 | Professional | None | $128.82 | $194.98 | $309.03 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $199.53 | Professional | None | $114.82 | $151.36 | $199.53 |
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 $144.54 Median $181.97 Typical High $281.84 | Professional | None | $144.54 | $181.97 | $281.84 |
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 $57.54 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $81.28 | $87.10 | $107.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $57.54 | $63.10 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $22.91 | $25.12 | $30.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $87.10 | $93.33 | $114.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $17.38 | $18.62 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $15.14 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $15.14 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $87.10 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $81.28 | $87.10 | $107.15 |
Where Maine sits
The same service costs 3.6 times more in Wisconsin 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· 31st of 51
$178
WI $468TX $129
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.