How much rates vary
Facilitymedian $1,778 · 10th to 90th $813 to $3,311Professionalmedian $724 · 10th to 90th $457 to $1,230
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 $446.68 Median $602.56 Typical High $602.56 | Professional | None | $446.68 | $602.56 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $724.44 Typical High $1,230.27 | Professional | None | $457.09 | $724.44 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,071.52 Typical High $1,862.09 | Professional | 50 · Both sides | $741.31 | $1,071.52 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $2,691.53 | Facility | None | $812.83 | $1,995.26 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,258.93 | Professional | None | $602.56 | $870.96 | $1,258.93 |
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 $524.81 Median $812.83 Typical High $1,230.27 | Professional | None | $524.81 | $812.83 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | None | $446.68 | $602.56 | $602.56 |
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 $630.96 Median $891.25 Typical High $1,230.27 | Professional | None | $630.96 | $891.25 | $1,230.27 |
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 $223.87 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $269.15 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $89.13 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $331.13 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $416.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $269.15 Typical High $302.00 | Professional | 52 · Reduced service | $223.87 | $269.15 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $89.13 | $109.65 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $331.13 | $407.38 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $81.28 Typical High $91.20 | Professional | 55 · Aftercare only | $66.07 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $60.26 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $60.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $309.03 | $380.19 | $416.87 |
Where Maine sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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
$741
AK $2,291KY $562
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.