How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,585 to $8,318Professionalmedian $2,042 · 10th to 90th $1,549 to $3,020
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 $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,621.81 | $2,041.74 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,548.82 | $2,041.74 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,344.23 Median $3,019.95 Typical High $4,570.88 | Professional | 50 · Both sides | $2,344.23 | $3,019.95 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,288.25 Typical High $1,905.46 | Professional | 62 · Two surgeons | $977.24 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $251.19 Median $323.59 Typical High $489.78 | Professional | 80 · Assistant surgeon | $251.19 | $323.59 | $489.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $218.78 Median $281.84 Typical High $426.58 | Professional | AS · PA/NP assist | $218.78 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $5,623.41 Typical High $9,120.11 | Facility | None | $1,584.89 | $5,623.41 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,238.72 | $3,235.94 |
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 $1,584.89 Median $1,995.26 Typical High $2,818.38 | Professional | None | $1,584.89 | $1,995.26 | $2,818.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | None | $1,905.46 | $2,041.74 | $2,041.74 |
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 $1,412.54 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,995.26 | $2,754.23 |
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 $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $812.83 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $323.59 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,202.26 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $239.88 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $954.99 | $1,023.29 | $1,023.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $380.19 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,412.54 | $1,548.82 | $1,548.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $281.84 | $309.03 | $309.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $190.55 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,445.44 | $1,445.44 |
Where Maine sits
The same service costs 20.0 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· 29th of 51
$2,042
AK $6,457TX $324
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.