How much rates vary
Facilitymedian $525 · 10th to 90th $87 to $14,454Professionalmedian $174 · 10th to 90th $126 to $251
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 $14,454.40 Median $14,454.40 Typical High $21,379.62 | Facility | None | $14,454.40 | $14,454.40 | $21,379.62 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $173.78 Typical High $251.19 | Professional | None | $131.83 | $173.78 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $234.42 | Professional | None | $120.23 | $158.49 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $125.89 Typical High $707.95 | Facility | None | $56.23 | $125.89 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $269.15 | Professional | None | $147.91 | $190.55 | $269.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $295.12 | Professional | None | $128.82 | $181.97 | $295.12 |
Martin's Point Setting Facility Modifier None Typical Low $14,454.40 Median $14,454.40 Typical High $21,379.62 | Facility | None | $14,454.40 | $14,454.40 | $21,379.62 |
Martin's Point Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $295.12 | Professional | None | $138.04 | $173.78 | $295.12 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $120.23 Median $169.82 Typical High $234.42 | Professional | None | $120.23 | $169.82 | $234.42 |
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 $70.79 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $70.79 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 53 · Discontinued | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $97.72 | $97.72 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $87.10 | Professional | 52 · Reduced service | $70.79 | $70.79 | $87.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 53 · Discontinued | $28.18 | $28.18 | $34.67 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 54 · Surgery only | $104.71 | $104.71 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $17.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $97.72 | $97.72 | $120.23 |
Where Maine sits
The same service costs 3.9 times more in Alaska than in Florida. 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
$174
AK $501FL $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.