How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $6,310Professionalmedian $2,951 · 10th to 90th $2,239 to $4,365
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 $2,398.83 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,398.83 | $2,951.21 | $2,951.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,238.72 | $2,884.03 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,412.54 Median $1,819.70 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,412.54 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $467.74 Typical High $691.83 | Professional | 80 · Assistant surgeon | $354.81 | $467.74 | $691.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $407.38 Typical High $616.60 | Professional | AS · PA/NP assist | $316.23 | $407.38 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,265.80 Typical High $6,918.31 | Facility | None | $707.95 | $4,265.80 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $4,677.35 | Professional | None | $2,570.40 | $3,235.94 | $4,677.35 |
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 $2,290.87 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,290.87 | $2,884.03 | $3,890.45 |
Martin's Point Setting Professional Modifier None Typical Low $2,691.53 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,951.21 | $2,951.21 |
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 $2,238.72 Median $2,884.03 Typical High $3,890.45 | Professional | None | $2,238.72 | $2,884.03 | $3,890.45 |
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 $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,174.90 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,778.28 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,659.59 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,348.96 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,348.96 | $1,479.11 | $1,479.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $537.03 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $537.03 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,041.74 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $2,041.74 | $2,187.76 | $2,187.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $407.38 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $269.15 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $269.15 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,905.46 | $2,041.74 | $2,041.74 |
Where Maine sits
The same service costs 21.9 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
$2,951
AK $9,333TX $427
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.