How much rates vary
Facilitymedian $1,259 · 10th to 90th $617 to $1,585Professionalmedian $219 · 10th to 90th $148 to $427
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 $208.93 Median $208.93 Typical High $416.87 | Professional | None | $208.93 | $208.93 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $275.42 | Professional | None | $120.23 | $186.21 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $190.55 Median $281.84 Typical High $389.05 | Professional | 50 · Both sides | $190.55 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $741.31 Typical High $1,862.09 | Facility | None | $616.60 | $741.31 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $512.86 | Professional | None | $208.93 | $309.03 | $512.86 |
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 $147.91 Median $257.04 Typical High $436.52 | Professional | None | $147.91 | $257.04 | $436.52 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $416.87 | Professional | None | $208.93 | $208.93 | $416.87 |
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 $144.54 Median $257.04 Typical High $436.52 | Professional | None | $144.54 | $257.04 | $436.52 |
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 $104.71 Median $104.71 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $104.71 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $83.18 | Professional | 53 · Discontinued | $41.69 | $41.69 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $309.03 | Professional | 54 · Surgery only | $158.49 | $158.49 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $63.10 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $288.40 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $208.93 | Professional | 52 · Reduced service | $104.71 | $104.71 | $208.93 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $83.18 | Professional | 53 · Discontinued | $41.69 | $41.69 | $83.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $158.49 Typical High $309.03 | Professional | 54 · Surgery only | $158.49 | $158.49 | $309.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $63.10 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $63.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $41.69 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $41.69 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $147.91 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $147.91 | $147.91 | $288.40 |
Where Maine sits
The same service costs 4.7 times more in Alaska than in Virginia. 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· 47th of 51
$219
AK $851VA $182
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.