How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $6,310Professionalmedian $1,023 · 10th to 90th $776 to $1,514
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 $812.83 Median $1,023.29 Typical High $1,023.29 | Professional | None | $812.83 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,513.56 | Professional | None | $776.25 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $141.25 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,659.59 | Professional | None | $891.25 | $1,096.48 | $1,659.59 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $794.33 Median $1,000.00 Typical High $1,412.54 | Professional | None | $794.33 | $1,000.00 | $1,412.54 |
Martin's Point Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,023.29 | Professional | None | $933.25 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,412.54 | Professional | None | $776.25 | $1,047.13 | $1,412.54 |
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 $407.38 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $407.38 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $162.18 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $616.60 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $123.03 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $81.28 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $467.74 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $186.21 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 54 · Surgery only | $707.95 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $141.25 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $93.33 | $102.33 | $102.33 |
Where Maine sits
The same service costs 4.6 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 $9,843KY $2,122
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.