How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $3,890Professionalmedian $955 · 10th to 90th $741 to $1,445
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 $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $1,479.11 | Professional | None | $741.31 | $977.24 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,122.02 Median $1,445.44 Typical High $2,187.76 | Professional | 50 · Both sides | $1,122.02 | $1,445.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $467.74 Median $616.60 Typical High $912.01 | Professional | 62 · Two surgeons | $467.74 | $616.60 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $120.23 Median $154.88 Typical High $234.42 | Professional | 80 · Assistant surgeon | $120.23 | $154.88 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | AS · PA/NP assist | $104.71 | $134.90 | $204.17 |
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 $741.31 Median $933.25 Typical High $1,348.96 | Professional | None | $741.31 | $933.25 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $954.99 Typical High $954.99 | Professional | None | $741.31 | $954.99 | $954.99 |
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 $724.44 Median $933.25 Typical High $1,258.93 | Professional | None | $724.44 | $933.25 | $1,258.93 |
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 $389.05 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $117.49 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $549.54 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $446.68 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $177.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $707.95 | Professional | 54 · Surgery only | $676.08 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $134.90 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $89.13 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $660.69 |
Where Maine sits
The same service costs 8.7 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· 31st of 51
$955
AK $3,090TX $355
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.