How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,042Professionalmedian $170 · 10th to 90th $115 to $275
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 $125.89 Median $169.82 Typical High $269.15 | Professional | None | $125.89 | $169.82 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $208.93 | Professional | None | $100.00 | $154.88 | $208.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $229.09 Typical High $316.23 | Professional | 50 · Both sides | $154.88 | $229.09 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,412.54 Typical High $2,238.72 | Facility | None | $537.03 | $1,412.54 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $338.84 | Professional | None | $169.82 | $223.87 | $338.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $275.42 | Professional | None | $120.23 | $186.21 | $275.42 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $269.15 | Professional | None | $125.89 | $169.82 | $269.15 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $275.42 | Professional | None | $112.20 | $186.21 | $275.42 |
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 $85.11 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $85.11 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $33.88 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $125.89 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | 52 · Reduced service | $85.11 | $85.11 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $53.70 | Professional | 53 · Discontinued | $33.88 | $33.88 | $53.70 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $125.89 Typical High $199.53 | Professional | 54 · Surgery only | $125.89 | $125.89 | $199.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $39.81 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $39.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $26.92 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $117.49 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $117.49 | $117.49 | $186.21 |
Where Maine sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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· 36th of 51
$170
AK $603KY $126
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.