How much rates vary
Facilitymedian $708 · 10th to 90th $398 to $1,202Professionalmedian $741 · 10th to 90th $525 to $933
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 $588.84 Median $758.58 Typical High $851.14 | Professional | None | $588.84 | $758.58 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $645.65 Typical High $933.25 | Professional | None | $436.52 | $645.65 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $691.83 | $1,023.29 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $1,412.54 | Facility | None | $338.84 | $537.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $1,023.29 | Professional | None | $676.08 | $794.33 | $1,023.29 |
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 $524.81 Median $676.08 Typical High $933.25 | Professional | None | $524.81 | $676.08 | $933.25 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $851.14 | Professional | None | $588.84 | $758.58 | $851.14 |
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 $501.19 Median $707.95 Typical High $912.01 | Professional | None | $501.19 | $707.95 | $912.01 |
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 $380.19 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $380.19 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $575.44 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $562.34 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | 52 · Reduced service | $380.19 | $380.19 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $158.49 | Professional | 53 · Discontinued | $154.88 | $154.88 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $575.44 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $120.23 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $79.43 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $79.43 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $562.34 |
Where Maine sits
The same service costs 6.2 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· 20th of 51
$741
AK $1,995UT $324
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.