How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $5,754Professionalmedian $1,585 · 10th to 90th $1,202 to $2,344
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 $1,258.93 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,202.26 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,202.26 | $1,548.82 | $2,344.23 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $758.58 Median $977.24 Typical High $1,479.11 | Professional | 62 · Two surgeons | $758.58 | $977.24 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $190.55 Median $251.19 Typical High $371.54 | Professional | 80 · Assistant surgeon | $190.55 | $251.19 | $371.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $218.78 Typical High $323.59 | Professional | AS · PA/NP assist | $165.96 | $218.78 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,388.44 Typical High $5,495.41 | Facility | None | $707.95 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,380.38 | $1,737.80 | $2,511.89 |
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 $1,230.27 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,548.82 | $2,137.96 |
Martin's Point Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
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 $1,174.90 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,174.90 | $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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $954.99 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $891.25 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $724.44 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $724.44 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $144.54 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,122.02 |
Where Maine sits
The same service costs 14.5 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· 30th of 51
$1,585
AK $4,898TX $339
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.