How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $6,607Professionalmedian $871 · 10th to 90th $617 to $1,122
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 $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | None | $758.58 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $812.83 Typical High $1,122.02 | Professional | None | $549.54 | $812.83 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,230.27 Typical High $1,698.24 | Professional | 50 · Both sides | $831.76 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $346.74 Median $512.86 Typical High $707.95 | Professional | 62 · Two surgeons | $346.74 | $512.86 | $707.95 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $6,606.93 | Facility | None | $1,513.56 | $2,238.72 | $6,606.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,202.26 | Professional | None | $645.65 | $912.01 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,023.29 | Professional | None | $758.58 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $6,606.93 | Facility | None | $1,513.56 | $2,238.72 | $6,606.93 |
United Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,202.26 | Professional | None | $676.08 | $1,000.00 | $1,202.26 |
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 $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $512.86 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $776.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $724.44 |
Where Maine sits
The same service costs 9.5 times more in Wyoming 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· 31st of 51
$912
WY $2,818UT $295
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.