How much rates vary
Facilitymedian $1,698 · 10th to 90th $331 to $3,236Professionalmedian $372 · 10th to 90th $245 to $575
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 $363.08 Median $363.08 Typical High $562.34 | Professional | None | $363.08 | $363.08 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $309.03 Typical High $446.68 | Professional | None | $199.53 | $309.03 | $446.68 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $323.59 Median $467.74 Typical High $660.69 | Professional | 50 · Both sides | $323.59 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $630.96 Typical High $3,235.94 | Facility | None | $281.84 | $630.96 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $707.95 | Professional | None | $354.81 | $457.09 | $707.95 |
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 $245.47 Median $407.38 Typical High $602.56 | Professional | None | $245.47 | $407.38 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $562.34 | Professional | None | $363.08 | $363.08 | $562.34 |
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 $257.04 Median $407.38 Typical High $602.56 | Professional | None | $257.04 | $407.38 | $602.56 |
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 $181.97 Median $181.97 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $181.97 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $74.13 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $275.42 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $181.97 Typical High $281.84 | Professional | 52 · Reduced service | $181.97 | $181.97 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $114.82 | Professional | 53 · Discontinued | $74.13 | $74.13 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $275.42 Typical High $426.58 | Professional | 54 · Surgery only | $275.42 | $275.42 | $426.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $85.11 | Professional | 55 · Aftercare only | $54.95 | $54.95 | $85.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | 56 · Pre-op care only | $36.31 | $36.31 | $56.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $257.04 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $257.04 | $257.04 | $398.11 |
Where Maine sits
The same service costs 3.9 times more in Wyoming 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
$372
WY $1,096UT $282
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.