How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $15,136Professionalmedian $2,754 · 10th to 90th $2,089 to $4,074
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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,754.23 Typical High $4,073.80 | Professional | None | $2,089.30 | $2,754.23 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,318.26 Median $1,737.80 Typical High $2,570.40 | Professional | 62 · Two surgeons | $1,318.26 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $331.13 Median $436.52 Typical High $660.69 | Professional | 80 · Assistant surgeon | $331.13 | $436.52 | $660.69 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $295.12 Median $380.19 Typical High $575.44 | Professional | AS · PA/NP assist | $295.12 | $380.19 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $10,232.93 Typical High $16,595.87 | Facility | None | $707.95 | $10,232.93 | $16,595.87 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,398.83 | $2,951.21 | $4,265.80 |
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 $2,089.30 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,754.23 | $3,715.35 |
Martin's Point Setting Professional Modifier None Typical Low $2,511.89 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,511.89 | $2,754.23 | $2,754.23 |
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 $2,089.30 Median $2,754.23 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,754.23 | $3,630.78 |
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 $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,122.02 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $446.68 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,659.59 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,659.59 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,905.46 | $1,905.46 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,258.93 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $501.19 Median $549.54 Typical High $549.54 | Professional | 53 · Discontinued | $501.19 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $2,041.74 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,905.46 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $380.19 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $251.19 Median $275.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $251.19 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,778.28 | $1,905.46 | $1,905.46 |
Where Maine sits
The same service costs 6.5 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· 30th of 51
$2,754
AK $8,710TX $1,349
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.