How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,148 to $5,754Professionalmedian $871 · 10th to 90th $646 to $1,230
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 $707.95 Median $776.25 Typical High $1,023.29 | Professional | None | $707.95 | $776.25 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,148.15 | Professional | None | $575.44 | $812.83 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,071.52 Typical High $1,380.38 | Professional | None | $812.83 | $1,071.52 | $1,380.38 |
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 $660.69 Median $1,000.00 Typical High $1,513.56 | Professional | None | $660.69 | $1,000.00 | $1,513.56 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,023.29 | Professional | None | $724.44 | $776.25 | $1,023.29 |
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 $616.60 Median $870.96 Typical High $1,380.38 | Professional | None | $616.60 | $870.96 | $1,380.38 |
14 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 $389.05 Median $389.05 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $389.05 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $575.44 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $128.82 Typical High $186.21 | Professional | 80 · Assistant surgeon | $93.33 | $128.82 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $112.20 Typical High $162.18 | Professional | AS · PA/NP assist | $83.18 | $112.20 | $162.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $512.86 | Professional | 52 · Reduced service | $389.05 | $389.05 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $204.17 | Professional | 53 · Discontinued | $154.88 | $154.88 | $204.17 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $575.44 Typical High $776.25 | Professional | 54 · Surgery only | $575.44 | $575.44 | $776.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $154.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $102.33 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $102.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $537.03 | $537.03 | $724.44 |
Where Maine sits
The same service costs 6.2 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
$871
AK $3,020TX $490
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.