How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $7,079Professionalmedian $3,548 · 10th to 90th $2,754 to $5,370
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 $2,818.38 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,818.38 | $3,548.13 | $3,548.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,754.23 Median $3,630.78 Typical High $5,370.32 | Professional | None | $2,754.23 | $3,630.78 | $5,370.32 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | 80 · Assistant surgeon | $446.68 | $575.44 | $870.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $501.19 Typical High $758.58 | Professional | AS · PA/NP assist | $389.05 | $501.19 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,168.69 Typical High $6,606.93 | Facility | None | $1,000.00 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,884.03 Median $3,890.45 Typical High $5,754.40 | Professional | None | $2,884.03 | $3,890.45 | $5,754.40 |
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 $2,754.23 Median $3,162.28 Typical High $4,897.79 | Professional | None | $2,754.23 | $3,162.28 | $4,897.79 |
Martin's Point Setting Professional Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,311.31 | $3,548.13 | $3,548.13 |
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 $2,454.71 Median $3,162.28 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,162.28 | $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 $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,412.54 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $562.34 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,089.30 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,089.30 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $426.58 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,949.84 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $1,949.84 | $2,511.89 | $2,511.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,659.59 | $1,778.28 | $1,778.28 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $660.69 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,511.89 | $2,691.53 | $2,691.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $501.19 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $331.13 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,344.23 | $2,511.89 | $2,511.89 |
Where Maine sits
The same service costs 19.5 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· 25th of 51
$3,548
AK $11,482TX $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.