How much rates vary
Facilitymedian $1,905 · 10th to 90th $708 to $4,898Professionalmedian $1,413 · 10th to 90th $1,047 to $1,905
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 $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,412.54 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,905.46 | Professional | None | $977.24 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | 62 · Two surgeons | $616.60 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $213.80 Typical High $309.03 | Professional | 80 · Assistant surgeon | $158.49 | $213.80 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $138.04 | $177.83 | $269.15 |
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 $1,148.15 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,148.15 | $1,445.44 | $2,187.76 |
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 $1,096.48 Median $1,318.26 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,318.26 | $1,995.26 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,096.48 | $1,412.54 | $1,412.54 |
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 $1,071.52 Median $1,479.11 Typical High $1,995.26 | Professional | None | $1,071.52 | $1,479.11 | $1,995.26 |
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 $588.84 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $891.25 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $177.83 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $831.76 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $616.60 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $245.47 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,047.13 Typical High $1,047.13 | Professional | 54 · Surgery only | $912.01 | $1,047.13 | $1,047.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $186.21 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $123.03 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $977.24 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $851.14 | $977.24 | $977.24 |
Where Maine sits
The same service costs 7.9 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· 28th of 51
$1,413
AK $4,074TX $513
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.