How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $708Professionalmedian $832 · 10th to 90th $661 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 $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,318.26 | Professional | None | $660.69 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $123.03 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $123.03 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,445.44 | Professional | None | $707.95 | $954.99 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,148.15 | Professional | None | $645.65 | $831.76 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $831.76 Typical High $831.76 | Professional | None | $812.83 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $630.96 Median $831.76 Typical High $1,122.02 | Professional | None | $630.96 | $831.76 | $1,122.02 |
10 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 $338.84 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $134.90 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $67.61 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $407.38 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $162.18 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $81.28 | $83.18 | $83.18 |
Where Maine sits
The same service costs 4.7 times more in Alaska than in Utah. 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· 30th of 51
$832
AK $2,754UT $589
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.