How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $2,818Professionalmedian $1,000 · 10th to 90th $646 to $1,288
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 $676.08 Median $1,000.00 Typical High $1,202.26 | Professional | None | $676.08 | $1,000.00 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,230.27 | Professional | None | $562.34 | $851.14 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,318.26 Typical High $1,862.09 | Professional | 50 · Both sides | $912.01 | $1,318.26 | $1,862.09 |
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 $954.99 Median $1,202.26 Typical High $1,479.11 | Professional | None | $954.99 | $1,202.26 | $1,479.11 |
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 $691.83 Median $977.24 Typical High $1,318.26 | Professional | None | $691.83 | $977.24 | $1,318.26 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $1,000.00 Typical High $1,202.26 | Professional | None | $676.08 | $1,000.00 | $1,202.26 |
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 $660.69 Median $1,000.00 Typical High $1,288.25 | Professional | None | $660.69 | $1,000.00 | $1,288.25 |
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 $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $831.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $501.19 Typical High $602.56 | Professional | 52 · Reduced service | $501.19 | $501.19 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $199.53 | $239.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $758.58 | $891.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $151.36 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $151.36 | $177.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $100.00 Typical High $120.23 | Professional | 56 · Pre-op care only | $100.00 | $100.00 | $120.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $831.76 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in West 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.
Physician feeFacility fee
AK $6,098WV $1,627
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.