How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $22,909Professionalmedian $4,169 · 10th to 90th $3,162 to $6,166
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 $3,388.44 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,388.44 | $4,073.80 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $6,165.95 | Professional | None | $3,162.28 | $4,168.69 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $4,786.30 Median $6,165.95 Typical High $9,332.54 | Professional | 50 · Both sides | $4,786.30 | $6,165.95 | $9,332.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,995.26 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $501.19 Median $660.69 Typical High $1,000.00 | Professional | 80 · Assistant surgeon | $501.19 | $660.69 | $1,000.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | AS · PA/NP assist | $446.68 | $575.44 | $870.96 |
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 $3,311.31 Median $4,466.84 Typical High $6,606.93 | Professional | None | $3,311.31 | $4,466.84 | $6,606.93 |
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 $3,162.28 Median $4,168.69 Typical High $5,623.41 | Professional | None | $3,162.28 | $4,168.69 | $5,623.41 |
Martin's Point Setting Professional Modifier None Typical Low $3,801.89 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,801.89 | $4,073.80 | $4,073.80 |
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 $3,019.95 Median $4,168.69 Typical High $5,623.41 | Professional | None | $3,019.95 | $4,168.69 | $5,623.41 |
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 $1,698.24 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,698.24 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $676.08 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,511.89 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $501.19 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $338.84 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,884.03 | $2,884.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,905.46 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $758.58 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,884.03 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,884.03 | $3,090.30 | $3,090.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $575.44 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $380.19 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,691.53 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,691.53 | $2,884.03 | $2,884.03 |
Where Maine sits
The same service costs 20.4 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
$4,074
AK $13,183TX $646
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.