How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $4,898Professionalmedian $871 · 10th to 90th $661 to $1,288
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 $724.44 Median $831.76 Typical High $831.76 | Professional | None | $724.44 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,288.25 | Professional | None | $660.69 | $851.14 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $138.04 Typical High $204.17 | Professional | 80 · Assistant surgeon | $104.71 | $138.04 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $91.20 | $120.23 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $954.99 Typical High $1,445.44 | Professional | None | $758.58 | $954.99 | $1,445.44 |
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 $660.69 Median $891.25 Typical High $1,202.26 | Professional | None | $660.69 | $891.25 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | None | $794.33 | $831.76 | $831.76 |
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 $630.96 Median $891.25 Typical High $1,202.26 | Professional | None | $630.96 | $891.25 | $1,202.26 |
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 $371.54 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $371.54 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $147.91 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $112.20 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $524.81 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $602.56 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $588.84 |
Where Maine sits
The same service costs 8.1 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
$891
AK $2,754TX $339
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.