How much rates vary
Facilitymedian $29,512 · 10th to 90th $2,344 to $30,200Professionalmedian $2,818 · 10th to 90th $1,622 to $3,802
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $23,442.29 Median $30,199.52 Typical High $30,902.95 | Facility | None | $23,442.29 | $30,199.52 | $30,902.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,818.38 Typical High $3,801.89 | Professional | None | $1,737.80 | $2,818.38 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $4,168.69 Typical High $5,754.40 | Professional | 50 · Both sides | $2,630.27 | $4,168.69 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,737.80 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,096.48 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $446.68 Typical High $616.60 | Professional | 80 · Assistant surgeon | $281.84 | $446.68 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $389.05 Typical High $537.03 | Professional | AS · PA/NP assist | $245.47 | $389.05 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,570.40 | $2,951.21 | $4,466.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,884.03 | $3,801.89 |
Martin's Point Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,162.28 Typical High $3,981.07 | Professional | None | $2,238.72 | $3,162.28 | $3,981.07 |
6 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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Maine sits
The same service costs 8.5 times more in Alaska than in Texas. 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· 20th of 51
$2,884
AK $8,128TX $955
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.