How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,079Professionalmedian $2,188 · 10th to 90th $1,660 to $3,388
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 $1,737.80 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,737.80 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,737.80 | $2,290.87 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,096.48 Median $1,445.44 Typical High $2,137.96 | Professional | 62 · Two surgeons | $1,096.48 | $1,445.44 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $281.84 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $245.47 Median $316.23 Typical High $478.63 | Professional | AS · PA/NP assist | $245.47 | $316.23 | $478.63 |
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 $1,737.80 Median $2,398.83 Typical High $3,467.37 | Professional | None | $1,737.80 | $2,398.83 | $3,467.37 |
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 $1,659.59 Median $2,187.76 Typical High $3,467.37 | Professional | None | $1,659.59 | $2,187.76 | $3,467.37 |
Martin's Point Setting Professional Modifier None Typical Low $2,041.74 Median $2,137.96 Typical High $2,137.96 | Professional | None | $2,041.74 | $2,137.96 | $2,137.96 |
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 $1,513.56 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,513.56 | $2,041.74 | $2,818.38 |
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,023.29 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,023.29 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $407.38 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $1,621.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $204.17 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,513.56 |
Where Maine sits
The same service costs 11.2 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· 24th of 51
$2,188
AK $7,244TX $646
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.