How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $5,754Professionalmedian $1,288 · 10th to 90th $977 to $1,905
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 $1,023.29 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,023.29 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,905.46 | Professional | None | $977.24 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,905.46 Typical High $2,884.03 | Professional | 50 · Both sides | $1,479.11 | $1,905.46 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | 62 · Two surgeons | $616.60 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $138.04 | $177.83 | $269.15 |
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 $1,122.02 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,122.02 | $1,412.54 | $2,041.74 |
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 $977.24 Median $1,258.93 Typical High $1,737.80 | Professional | None | $977.24 | $1,258.93 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,202.26 | $1,288.25 | $1,288.25 |
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 $912.01 Median $1,258.93 Typical High $1,698.24 | Professional | None | $912.01 | $1,258.93 | $1,698.24 |
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 $512.86 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $512.86 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $204.17 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $776.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $724.44 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $588.84 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $239.88 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $120.23 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $891.25 |
Where Maine sits
The same service costs 18.2 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
$1,288
AK $4,074TX $224
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.