How much rates vary
Facilitymedian $2,512 · 10th to 90th $813 to $5,754Professionalmedian $1,514 · 10th to 90th $1,175 to $2,188
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,230.27 | $1,513.56 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,122.02 | $1,445.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $707.95 Median $912.01 Typical High $1,380.38 | Professional | 62 · Two surgeons | $707.95 | $912.01 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $234.42 Typical High $346.74 | Professional | 80 · Assistant surgeon | $177.83 | $234.42 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | AS · PA/NP assist | $158.49 | $204.17 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $3,388.44 Typical High $5,495.41 | Facility | None | $812.83 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,454.71 | Professional | None | $1,288.25 | $1,698.24 | $2,454.71 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,479.11 | $2,089.30 |
Martin's Point Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,513.56 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,148.15 | $1,548.82 | $2,089.30 |
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 $616.60 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $758.58 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 54 · Surgery only | $1,071.52 | $1,148.15 | $1,148.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $229.09 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,071.52 | $1,071.52 |
Where Maine sits
The same service costs 16.6 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
$1,549
AK $4,677TX $282
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.