How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $6,026Professionalmedian $832 · 10th to 90th $661 to $1,288
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 $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $891.25 Typical High $1,318.26 | Professional | None | $691.83 | $891.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,348.96 Typical High $1,995.26 | Professional | 50 · Both sides | $1,023.29 | $1,348.96 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $562.34 Typical High $831.76 | Professional | 62 · Two surgeons | $426.58 | $562.34 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $4,168.69 Typical High $6,606.93 | Facility | None | $1,000.00 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,412.54 | Professional | None | $758.58 | $933.25 | $1,412.54 |
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 $645.65 Median $831.76 Typical High $1,258.93 | Professional | None | $645.65 | $831.76 | $1,258.93 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $831.76 | Professional | None | $676.08 | $831.76 | $831.76 |
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 $630.96 Median $831.76 Typical High $1,122.02 | Professional | None | $630.96 | $831.76 | $1,122.02 |
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 $346.74 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $524.81 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $104.71 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $70.79 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $489.78 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $398.11 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $158.49 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $588.84 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $117.49 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $79.43 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $549.54 | $588.84 | $588.84 |
Where Maine sits
The same service costs 4.8 times more in Alaska 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
AK $10,454MT $2,169
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.