How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $22,387Professionalmedian $2,291 · 10th to 90th $1,778 to $3,548
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 $1,778.28 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,778.28 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,344.23 Typical High $3,548.13 | Professional | None | $1,778.28 | $2,344.23 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,122.02 Median $1,479.11 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,122.02 | $1,479.11 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $281.84 Median $371.54 Typical High $562.34 | Professional | 80 · Assistant surgeon | $281.84 | $371.54 | $562.34 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $251.19 Median $323.59 Typical High $489.78 | Professional | AS · PA/NP assist | $251.19 | $323.59 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $15,488.17 Typical High $24,547.09 | Facility | None | $707.95 | $15,488.17 | $24,547.09 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,041.74 | $2,511.89 | $3,630.78 |
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 $1,778.28 Median $2,290.87 Typical High $3,388.44 | Professional | None | $1,778.28 | $2,290.87 | $3,388.44 |
Martin's Point Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,862.09 | $2,290.87 | $2,290.87 |
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 $1,737.80 Median $2,290.87 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,290.87 | $3,090.30 |
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $933.25 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $371.54 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,412.54 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $281.84 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,584.89 | $1,584.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,071.52 | $1,148.15 | $1,148.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $426.58 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,698.24 Typical High $1,698.24 | Professional | 54 · Surgery only | $1,584.89 | $1,698.24 | $1,698.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $323.59 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $213.80 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,584.89 | $1,584.89 |
Where Maine sits
The same service costs 5.8 times more in Wyoming 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
WY $23,320KY $4,000
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.