How much rates vary
Facilitymedian $1,259 · 10th to 90th $759 to $1,698Professionalmedian $490 · 10th to 90th $339 to $741
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 $407.38 Median $407.38 Typical High $660.69 | Professional | None | $407.38 | $407.38 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $645.65 | Professional | None | $323.59 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $891.25 Typical High $2,290.87 | Facility | None | $741.31 | $891.25 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $776.25 | Professional | None | $426.58 | $645.65 | $776.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $1,047.13 | Professional | None | $346.74 | $549.54 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $660.69 | Professional | None | $407.38 | $407.38 | $660.69 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $741.31 | Professional | None | $309.03 | $489.78 | $741.31 |
15 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 $204.17 Median $204.17 Typical High $331.13 | Professional | 52 · Reduced service | $204.17 | $204.17 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $131.83 | Professional | 53 · Discontinued | $81.28 | $81.28 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $309.03 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $66.07 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $676.08 Typical High $954.99 | Professional | 50 · Both sides | $489.78 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $52.48 Median $72.44 Typical High $102.33 | Professional | 80 · Assistant surgeon | $52.48 | $72.44 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $45.71 Median $63.10 Typical High $89.13 | Professional | AS · PA/NP assist | $45.71 | $63.10 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $204.17 Typical High $331.13 | Professional | 52 · Reduced service | $204.17 | $204.17 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $131.83 | Professional | 53 · Discontinued | $81.28 | $81.28 | $131.83 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $309.03 Typical High $489.78 | Professional | 54 · Surgery only | $309.03 | $309.03 | $489.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $97.72 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $66.07 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $66.07 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $288.40 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $288.40 | $288.40 | $457.09 |
Where Maine sits
The same service costs 5.1 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· 29th of 51
$501
AK $1,585TX $309
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.