How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $5,754Professionalmedian $2,884 · 10th to 90th $2,188 to $4,266
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 $2,238.72 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,238.72 | $2,884.03 | $2,884.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,818.38 Typical High $4,265.80 | Professional | None | $2,187.76 | $2,818.38 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,778.28 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,380.38 | $1,778.28 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $457.09 Typical High $676.08 | Professional | 80 · Assistant surgeon | $346.74 | $457.09 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $398.11 Typical High $602.56 | Professional | AS · PA/NP assist | $302.00 | $398.11 | $602.56 |
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 $2,344.23 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,344.23 | $3,162.28 | $4,570.88 |
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 $2,187.76 Median $2,511.89 Typical High $3,890.45 | Professional | None | $2,187.76 | $2,511.89 | $3,890.45 |
Martin's Point Setting Professional Modifier None Typical Low $2,630.27 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,630.27 | $2,884.03 | $2,884.03 |
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 $1,949.84 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,949.84 | $2,570.40 | $3,630.78 |
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 $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,122.02 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $446.68 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,659.59 | $2,187.76 | $2,187.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $338.84 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $223.87 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,548.82 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,318.26 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $524.81 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,187.76 Typical High $2,187.76 | Professional | 54 · Surgery only | $1,995.26 | $2,187.76 | $2,187.76 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $436.52 Typical High $436.52 | Professional | 55 · Aftercare only | $398.11 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $263.03 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $2,041.74 Typical High $2,041.74 | Professional | 78 · Unplanned return to OR | $1,862.09 | $2,041.74 | $2,041.74 |
Where Maine sits
The same service costs 21.4 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· 23rd of 51
$2,884
AK $9,120TX $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.