How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,072 to $3,236Professionalmedian $490 · 10th to 90th $380 to $813
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 $371.54 Median $416.87 Typical High $660.69 | Professional | None | $371.54 | $416.87 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $489.78 Typical High $724.44 | Professional | None | $331.13 | $489.78 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,995.26 Typical High $3,235.94 | Facility | None | $1,122.02 | $1,995.26 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $891.25 | Professional | None | $416.87 | $478.63 | $891.25 |
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 $426.58 Median $562.34 Typical High $831.76 | Professional | None | $426.58 | $562.34 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $660.69 | Professional | None | $371.54 | $416.87 | $660.69 |
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 $407.38 Median $562.34 Typical High $776.25 | Professional | None | $407.38 | $562.34 | $776.25 |
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 $208.93 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $323.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $208.93 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | 53 · Discontinued | $83.18 | $83.18 | $93.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $309.03 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $46.77 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $323.59 |
Where Maine sits
The same service costs 4.3 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· 29th of 51
$490
AK $1,380UT $324
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.