How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $15,488Professionalmedian $2,455 · 10th to 90th $1,905 to $3,802
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 $1,949.84 Median $2,398.83 Typical High $2,398.83 | Professional | None | $1,949.84 | $2,398.83 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $3,801.89 | Professional | None | $1,949.84 | $2,511.89 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,584.89 Typical High $2,398.83 | Professional | 62 · Two surgeons | $1,230.27 | $1,584.89 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $309.03 Median $407.38 Typical High $616.60 | Professional | 80 · Assistant surgeon | $309.03 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $269.15 Median $354.81 Typical High $537.03 | Professional | AS · PA/NP assist | $269.15 | $354.81 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $10,715.19 Typical High $16,982.44 | Facility | None | $707.95 | $10,715.19 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $3,890.45 | Professional | None | $2,137.96 | $2,691.53 | $3,890.45 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,862.09 Median $2,454.71 Typical High $3,715.35 | Professional | None | $1,862.09 | $2,454.71 | $3,715.35 |
Martin's Point Setting Professional Modifier None Typical Low $2,290.87 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,290.87 | $2,398.83 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,778.28 | $2,454.71 | $3,235.94 |
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 $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $977.24 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $398.11 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,479.11 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,148.15 | $1,202.26 | $1,202.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $457.09 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,778.28 Typical High $1,778.28 | Professional | 54 · Surgery only | $1,698.24 | $1,778.28 | $1,778.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $338.84 | $363.08 | $363.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $229.09 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,659.59 | $1,659.59 |
Where Maine sits
The same service costs 16.2 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· 31st of 51
$2,455
AK $8,128TX $501
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.