How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $4,266Professionalmedian $575 · 10th to 90th $447 to $891
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 $467.74 Median $575.44 Typical High $575.44 | Professional | None | $467.74 | $575.44 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $891.25 | Professional | None | $457.09 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $891.25 Typical High $1,348.96 | Professional | 50 · Both sides | $691.83 | $891.25 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $288.40 Median $371.54 Typical High $562.34 | Professional | 62 · Two surgeons | $288.40 | $371.54 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $2,238.72 Typical High $4,466.84 | Facility | None | $1,584.89 | $2,238.72 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $933.25 | Professional | None | $524.81 | $645.65 | $933.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | None | $436.52 | $562.34 | $851.14 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | None | $537.03 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $436.52 Median $562.34 Typical High $758.58 | Professional | None | $436.52 | $562.34 | $758.58 |
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 $234.42 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $354.81 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $70.79 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $46.77 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $331.13 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $269.15 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $109.65 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $407.38 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $81.28 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $53.70 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $380.19 | $407.38 | $407.38 |
Where Maine sits
The same service costs 5.1 times more in Washington, DC than in Montana. 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
DC $7,757MT $1,518
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.