How much rates vary
Facilitymedian $708 · 10th to 90th $407 to $1,202Professionalmedian $759 · 10th to 90th $513 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 $758.58 Median $794.33 Typical High $812.83 | Professional | None | $758.58 | $794.33 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $933.25 | Professional | None | $436.52 | $676.08 | $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 $346.74 Median $537.03 Typical High $1,412.54 | Facility | None | $346.74 | $537.03 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,122.02 | Professional | None | $676.08 | $812.83 | $1,122.02 |
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 $691.83 Typical High $1,000.00 | Professional | None | $524.81 | $691.83 | $1,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
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 $512.86 Median $724.44 Typical High $977.24 | Professional | None | $512.86 | $724.44 | $977.24 |
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 $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $575.44 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $575.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $380.19 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $380.19 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $162.18 | Professional | 53 · Discontinued | $154.88 | $154.88 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $616.60 | Professional | 54 · Surgery only | $575.44 | $575.44 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $114.82 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $75.86 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $575.44 |
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· 25th of 51
$759
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.