How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,585 to $6,310Professionalmedian $1,072 · 10th to 90th $813 to $1,622
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 $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | None | $851.14 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | 62 · Two surgeons | $524.81 | $676.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $173.78 Typical High $257.04 | Professional | 80 · Assistant surgeon | $131.83 | $173.78 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $151.36 Typical High $223.87 | Professional | AS · PA/NP assist | $114.82 | $151.36 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,466.84 Typical High $6,918.31 | Facility | None | $1,584.89 | $4,466.84 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,174.90 Typical High $1,698.24 | Professional | None | $954.99 | $1,174.90 | $1,698.24 |
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 $812.83 Median $1,047.13 Typical High $1,479.11 | Professional | None | $812.83 | $1,047.13 | $1,479.11 |
Martin's Point Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
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 $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $776.25 | $1,047.13 | $1,412.54 |
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 $426.58 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $426.58 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $169.82 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $128.82 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $85.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $602.56 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $741.31 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $147.91 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 78 · Unplanned return to OR | $691.83 | $741.31 | $741.31 |
Where Maine sits
The same service costs 22.4 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· 28th of 51
$1,072
AK $3,388TX $151
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.