How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $8,511Professionalmedian $3,311 · 10th to 90th $2,570 to $5,012
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 $2,754.23 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,754.23 | $3,311.31 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $5,011.87 | Professional | None | $2,570.40 | $3,311.31 | $5,011.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,621.81 Median $2,089.30 Typical High $3,162.28 | Professional | 62 · Two surgeons | $1,621.81 | $2,089.30 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $407.38 Median $537.03 Typical High $812.83 | Professional | 80 · Assistant surgeon | $407.38 | $537.03 | $812.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | AS · PA/NP assist | $363.08 | $467.74 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,309.57 Typical High $8,511.38 | Facility | None | $707.95 | $6,309.57 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $3,630.78 Typical High $5,248.07 | Professional | None | $2,951.21 | $3,630.78 | $5,248.07 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $4,570.88 | Professional | None | $2,570.40 | $3,311.31 | $4,570.88 |
Martin's Point Setting Professional Modifier None Typical Low $3,090.30 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,090.30 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,511.89 Median $3,311.31 Typical High $4,466.84 | Professional | None | $2,511.89 | $3,311.31 | $4,466.84 |
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 $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,348.96 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $549.54 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,041.74 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $407.38 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,344.23 | $2,344.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,548.82 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $616.60 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,344.23 | $2,511.89 | $2,511.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $467.74 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $309.03 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,344.23 | $2,344.23 |
Where Maine sits
The same service costs 8.7 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· 29th of 51
$3,311
AK $10,715TX $1,230
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.