How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,079Professionalmedian $3,020 · 10th to 90th $2,344 to $4,677
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 $2,398.83 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,398.83 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,398.83 Median $3,162.28 Typical High $4,677.35 | Professional | None | $2,398.83 | $3,162.28 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,513.56 Median $1,995.26 Typical High $2,951.21 | Professional | 62 · Two surgeons | $1,513.56 | $1,995.26 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $389.05 Median $501.19 Typical High $758.58 | Professional | 80 · Assistant surgeon | $389.05 | $501.19 | $758.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $338.84 Median $416.87 Typical High $660.69 | Professional | AS · PA/NP assist | $338.84 | $416.87 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,311.31 Typical High $4,897.79 | Professional | None | $2,630.27 | $3,311.31 | $4,897.79 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $4,466.84 | Professional | None | $2,344.23 | $3,019.95 | $4,466.84 |
Martin's Point Setting Professional Modifier None Typical Low $2,398.83 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,398.83 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $2,238.72 Median $3,019.95 Typical High $4,073.80 | Professional | None | $2,238.72 | $3,019.95 | $4,073.80 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $501.19 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,862.09 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,862.09 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $371.54 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,737.80 | $2,137.96 | $2,137.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,412.54 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $575.44 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $2,137.96 | $2,290.87 | $2,290.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $426.58 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $288.40 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $1,995.26 | $2,137.96 | $2,137.96 |
Where Maine sits
The same service costs 4.0 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.
Physician feeFacility fee
AK $19,772TX $4,915
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.