How much rates vary
Facilitymedian $1,698 · 10th to 90th $229 to $2,818Professionalmedian $331 · 10th to 90th $229 to $550
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 $229.09 Typical High $281.84 | Facility | None | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $489.78 | Professional | None | $229.09 | $281.84 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $562.34 | Professional | None | $218.78 | $331.13 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $3,090.30 | Facility | None | $707.95 | $1,862.09 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $416.87 Typical High $575.44 | Professional | None | $302.00 | $416.87 | $575.44 |
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 $263.03 Median $371.54 Typical High $562.34 | Professional | None | $263.03 | $371.54 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $489.78 | Professional | None | $229.09 | $281.84 | $489.78 |
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 $269.15 Median $363.08 Typical High $524.81 | Professional | None | $269.15 | $363.08 | $524.81 |
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 $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $114.82 | $117.49 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $162.18 | $165.96 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $117.49 Typical High $141.25 | Professional | 52 · Reduced service | $114.82 | $117.49 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $46.77 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $46.77 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $177.83 | $213.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $35.48 Typical High $42.66 | Professional | 55 · Aftercare only | $34.67 | $35.48 | $42.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $23.44 | $28.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $162.18 | $165.96 | $199.53 |
Where Maine sits
The same service costs 8.5 times more in Alaska than in West Virginia. 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.
Physician feeFacility fee
AK $5,029WV $590
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.