How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,585 to $5,754Professionalmedian $1,023 · 10th to 90th $776 to $1,514
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 $794.33 Median $1,023.29 Typical High $1,174.90 | Professional | None | $794.33 | $1,023.29 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,023.29 Typical High $1,548.82 | Professional | None | $776.25 | $1,023.29 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,174.90 Median $1,513.56 Typical High $2,290.87 | Professional | 50 · Both sides | $1,174.90 | $1,513.56 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $645.65 Typical High $977.24 | Professional | 62 · Two surgeons | $489.78 | $645.65 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $125.89 Median $162.18 Typical High $245.47 | Professional | 80 · Assistant surgeon | $125.89 | $162.18 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | AS · PA/NP assist | $109.65 | $141.25 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $5,495.41 | Facility | None | $1,584.89 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,122.02 Typical High $1,621.81 | Professional | None | $891.25 | $1,122.02 | $1,621.81 |
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 $776.25 Median $1,000.00 Typical High $1,380.38 | Professional | None | $776.25 | $1,000.00 | $1,380.38 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $1,023.29 Typical High $1,174.90 | Professional | None | $812.83 | $1,023.29 | $1,174.90 |
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 $724.44 Median $1,000.00 Typical High $1,348.96 | Professional | None | $724.44 | $1,000.00 | $1,348.96 |
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 $407.38 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $478.63 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $190.55 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $660.69 | $707.95 | $707.95 |
Where Maine sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $10,315KY $2,095
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.