How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $708Professionalmedian $398 · 10th to 90th $309 to $603
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 $302.00 Median $398.11 Typical High $398.11 | Professional | None | $302.00 | $398.11 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $616.60 | Professional | None | $309.03 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $194.98 Median $257.04 Typical High $389.05 | Professional | 62 · Two surgeons | $194.98 | $257.04 | $389.05 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $50.12 Median $64.57 Typical High $97.72 | Professional | 80 · Assistant surgeon | $50.12 | $64.57 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $43.65 Median $56.23 Typical High $85.11 | Professional | AS · PA/NP assist | $43.65 | $56.23 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $8,912.51 | Facility | None | $691.83 | $707.95 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $630.96 | Professional | None | $354.81 | $436.52 | $630.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $549.54 | Professional | None | $309.03 | $398.11 | $549.54 |
Martin's Point Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $398.11 | Professional | None | $302.00 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $537.03 | Professional | None | $302.00 | $398.11 | $537.03 |
10 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 $158.49 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $63.10 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $239.88 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $186.21 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $74.13 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $275.42 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $54.95 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $37.15 | $39.81 | $39.81 |
Where Maine sits
The same service costs 85.4 times more in Michigan than in Delaware. 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
MI $39,331DE $460
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.