How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $6,310Professionalmedian $912 · 10th to 90th $692 to $1,349
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 $912.01 Typical High $912.01 | Professional | None | $724.44 | $912.01 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,348.96 | Professional | None | $691.83 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $112.20 Median $154.88 Typical High $218.78 | Professional | 80 · Assistant surgeon | $112.20 | $154.88 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $128.82 Typical High $190.55 | Professional | AS · PA/NP assist | $97.72 | $128.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,265.80 Typical High $6,918.31 | Facility | None | $707.95 | $4,265.80 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,479.11 | Professional | None | $794.33 | $1,023.29 | $1,479.11 |
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 $691.83 Median $831.76 Typical High $1,288.25 | Professional | None | $691.83 | $831.76 | $1,288.25 |
Martin's Point Setting Professional Modifier None Typical Low $851.14 Median $912.01 Typical High $912.01 | Professional | None | $851.14 | $912.01 | $912.01 |
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 $630.96 Median $851.14 Typical High $1,202.26 | Professional | None | $630.96 | $851.14 | $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 $363.08 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $363.08 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $537.03 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $107.15 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $72.44 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $501.19 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $426.58 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $169.82 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $645.65 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $128.82 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $85.11 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $602.56 | $645.65 | $645.65 |
Where Maine sits
The same service costs 19.1 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· 27th of 51
$912
AK $2,884TX $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.