How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $37,154Professionalmedian $1,950 · 10th to 90th $1,514 to $3,020
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 $1,548.82 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,949.84 | $2,398.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,995.26 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | 62 · Two surgeons | $977.24 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $323.59 Typical High $478.63 | Professional | 80 · Assistant surgeon | $245.47 | $323.59 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | AS · PA/NP assist | $213.80 | $281.84 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $28,183.83 Typical High $37,153.52 | Facility | None | $707.95 | $28,183.83 | $37,153.52 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,737.80 | $2,137.96 | $3,162.28 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $19,054.61 | Facility | None | $2,818.38 | $3,019.95 | $19,054.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,949.84 | $2,951.21 |
Martin's Point Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,398.83 | Professional | None | $1,548.82 | $1,949.84 | $2,398.83 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $19,054.61 | Facility | None | $2,818.38 | $3,019.95 | $19,054.61 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $2,630.27 | Professional | None | $1,479.11 | $1,949.84 | $2,630.27 |
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 $794.33 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $323.59 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $323.59 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $162.18 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,122.02 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $912.01 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $371.54 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $275.42 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $186.21 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,348.96 |
Where Maine sits
The same service costs 10.9 times more in Alaska than in Kentucky. 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 $39,570KY $3,638
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.