How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $6,310Professionalmedian $1,778 · 10th to 90th $1,380 to $2,692
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 $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,778.28 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $288.40 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $288.40 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $251.19 Typical High $380.19 | Professional | AS · PA/NP assist | $190.55 | $251.19 | $380.19 |
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 $1,513.56 Median $1,949.84 Typical High $2,818.38 | Professional | None | $1,513.56 | $1,949.84 | $2,818.38 |
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 $1,380.38 Median $1,584.89 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,584.89 | $2,454.71 |
Martin's Point Setting Professional Modifier None Typical Low $1,659.59 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,659.59 | $1,778.28 | $1,778.28 |
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 $1,230.27 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,659.59 | $2,290.87 |
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 $707.95 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,047.13 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $208.93 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $977.24 | $1,258.93 | $1,258.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $831.76 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $331.13 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,230.27 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $251.19 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $165.96 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,258.93 | $1,258.93 |
Where Maine sits
The same service costs 20.0 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· 26th of 51
$1,778
AK $5,754TX $288
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.