How much rates vary
Facilitymedian $1,738 · 10th to 90th $708 to $2,818Professionalmedian $1,318 · 10th to 90th $1,023 to $2,138
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 $1,047.13 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,047.13 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,412.54 | $2,137.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $2,818.38 | Facility | None | $707.95 | $1,288.25 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,318.26 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,318.26 | $2,041.74 |
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 $1,023.29 Median $1,348.96 Typical High $2,089.30 | Professional | None | $1,023.29 | $1,348.96 | $2,089.30 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $912.01 Median $1,202.26 Typical High $1,698.24 | Professional | None | $912.01 | $1,202.26 | $1,698.24 |
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 $524.81 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $524.81 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $208.93 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $104.71 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $616.60 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | 54 · Surgery only | $912.01 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $870.96 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $851.14 | $870.96 | $870.96 |
Where Maine sits
The same service costs 5.9 times more in Alaska 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· 27th of 51
$1,318
AK $4,467TX $759
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.