How much rates vary
Facilitymedian $1,698 · 10th to 90th $398 to $2,570Professionalmedian $525 · 10th to 90th $347 to $692
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 $354.81 Median $524.81 Typical High $630.96 | Professional | None | $354.81 | $524.81 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $645.65 | Professional | None | $302.00 | $457.09 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $478.63 Median $707.95 Typical High $977.24 | Professional | 50 · Both sides | $478.63 | $707.95 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $691.83 Typical High $2,290.87 | Facility | None | $338.84 | $691.83 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $831.76 | Professional | None | $512.86 | $660.69 | $831.76 |
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 $371.54 Median $524.81 Typical High $691.83 | Professional | None | $371.54 | $524.81 | $691.83 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $524.81 Typical High $630.96 | Professional | None | $354.81 | $524.81 | $630.96 |
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 $346.74 Median $512.86 Typical High $676.08 | Professional | None | $346.74 | $512.86 | $676.08 |
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 $263.03 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $263.03 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $446.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $263.03 Typical High $316.23 | Professional | 52 · Reduced service | $263.03 | $263.03 | $316.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $104.71 | $104.71 | $128.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | 54 · Surgery only | $389.05 | $389.05 | $478.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $95.50 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $52.48 | $52.48 | $63.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $363.08 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $363.08 | $363.08 | $446.68 |
Where Maine sits
The same service costs 5.0 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· 21st of 51
$525
AK $1,380UT $275
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.