How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,349 to $4,898Professionalmedian $977 · 10th to 90th $724 to $1,445
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 $724.44 Median $977.24 Typical High $977.24 | Professional | None | $724.44 | $977.24 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,445.44 | Professional | None | $724.44 | $954.99 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $151.36 Typical High $229.09 | Professional | 80 · Assistant surgeon | $117.49 | $151.36 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $131.83 Typical High $199.53 | Professional | AS · PA/NP assist | $102.33 | $131.83 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $5,495.41 | Facility | None | $1,584.89 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,047.13 Typical High $1,548.82 | Professional | None | $831.76 | $1,047.13 | $1,548.82 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,348.96 | Professional | None | $741.31 | $870.96 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $977.24 | Professional | None | $758.58 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,230.27 | Professional | None | $660.69 | $870.96 | $1,230.27 |
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 $380.19 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $151.36 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $112.20 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $75.86 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $446.68 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $177.83 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 54 · Surgery only | $660.69 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $131.83 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $89.13 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $676.08 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $616.60 | $676.08 | $676.08 |
Where Maine sits
The same service costs 17.4 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· 25th of 51
$977
AK $3,020TX $174
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.