How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $2,818Professionalmedian $479 · 10th to 90th $331 to $759
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 $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $436.52 Typical High $588.84 | Professional | None | $281.84 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $660.69 Typical High $891.25 | Professional | 50 · Both sides | $436.52 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $2,290.87 | Facility | None | $812.83 | $1,479.11 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $912.01 | Professional | None | $478.63 | $616.60 | $912.01 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $758.58 | Professional | None | $346.74 | $524.81 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $724.44 | Professional | None | $478.63 | $478.63 | $724.44 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $316.23 Median $524.81 Typical High $758.58 | Professional | None | $316.23 | $524.81 | $758.58 |
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 $239.88 Median $239.88 Typical High $363.08 | Professional | 52 · Reduced service | $239.88 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 53 · Discontinued | $95.50 | $95.50 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | 54 · Surgery only | $354.81 | $354.81 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $109.65 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $72.44 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $512.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $239.88 Typical High $363.08 | Professional | 52 · Reduced service | $239.88 | $239.88 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | 53 · Discontinued | $95.50 | $95.50 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | 54 · Surgery only | $354.81 | $354.81 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $109.65 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $47.86 Typical High $72.44 | Professional | 56 · Pre-op care only | $47.86 | $47.86 | $72.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $512.86 |
Where Maine sits
The same service costs 5.9 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· 28th of 51
$479
AK $1,698UT $288
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.