How much rates vary
Facilitymedian $708 · 10th to 90th $245 to $1,202Professionalmedian $427 · 10th to 90th $295 to $891
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 $389.05 Median $457.09 Typical High $602.56 | Professional | None | $389.05 | $457.09 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $512.86 | Professional | None | $239.88 | $354.81 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $562.34 Typical High $776.25 | Professional | 50 · Both sides | $380.19 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $457.09 Typical High $1,412.54 | Facility | None | $208.93 | $457.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $616.60 | Professional | None | $371.54 | $457.09 | $616.60 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $1,071.52 | Professional | None | $295.12 | $446.68 | $1,071.52 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $602.56 | Professional | None | $389.05 | $457.09 | $602.56 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $281.84 Median $602.56 Typical High $1,096.48 | Professional | None | $281.84 | $602.56 | $1,096.48 |
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 $208.93 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $208.93 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $85.11 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $316.23 | $316.23 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | 52 · Reduced service | $208.93 | $208.93 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $85.11 | $85.11 | $91.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $338.84 | Professional | 54 · Surgery only | $316.23 | $316.23 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $45.71 | Professional | 56 · Pre-op care only | $42.66 | $42.66 | $45.71 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $295.12 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $295.12 | $295.12 | $316.23 |
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· 32nd of 51
$427
AK $1,096UT $219
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.