How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $22,909Professionalmedian $3,467 · 10th to 90th $2,692 to $5,248
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 $2,691.53 Median $3,467.37 Typical High $3,467.37 | Professional | None | $2,691.53 | $3,467.37 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $5,248.07 | Professional | None | $2,691.53 | $3,467.37 | $5,248.07 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,981.07 Median $5,248.07 Typical High $7,762.47 | Professional | 50 · Both sides | $3,981.07 | $5,248.07 | $7,762.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,698.24 Median $2,187.76 Typical High $3,311.31 | Professional | 62 · Two surgeons | $1,698.24 | $2,187.76 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | 80 · Assistant surgeon | $426.58 | $562.34 | $831.76 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $371.54 Median $489.78 Typical High $724.44 | Professional | AS · PA/NP assist | $371.54 | $489.78 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $15,488.17 Typical High $25,118.86 | Facility | None | $707.95 | $15,488.17 | $25,118.86 |
Cigna Setting Professional Modifier None Typical Low $2,818.38 Median $3,801.89 Typical High $5,495.41 | Professional | None | $2,818.38 | $3,801.89 | $5,495.41 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,090.30 | $4,786.30 |
Martin's Point Setting Professional Modifier None Typical Low $3,235.94 Median $3,467.37 Typical High $3,467.37 | Professional | None | $3,235.94 | $3,467.37 | $3,467.37 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,162.28 Typical High $4,365.16 | Professional | None | $2,344.23 | $3,162.28 | $4,365.16 |
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 $1,348.96 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,348.96 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $549.54 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,041.74 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $407.38 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $269.15 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,398.83 | $2,398.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,737.80 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,621.81 | $1,737.80 | $1,737.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 53 · Discontinued | $645.65 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,398.83 | $2,570.40 | $2,570.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $478.63 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 56 · Pre-op care only | $323.59 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,238.72 | $2,398.83 | $2,398.83 |
Where Maine sits
The same service costs 20.0 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· 27th of 51
$3,467
AK $11,220TX $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.