How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $6,026Professionalmedian $794 · 10th to 90th $603 to $1,230
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 $645.65 Median $794.33 Typical High $794.33 | Professional | None | $645.65 | $794.33 | $794.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,230.27 | Professional | None | $616.60 | $812.83 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,230.27 Typical High $1,819.70 | Professional | 50 · Both sides | $933.25 | $1,230.27 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $194.98 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $194.98 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $114.82 Typical High $169.82 | Professional | AS · PA/NP assist | $87.10 | $114.82 | $169.82 |
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 $724.44 Median $891.25 Typical High $1,288.25 | Professional | None | $724.44 | $891.25 | $1,288.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,148.15 | Professional | None | $602.56 | $776.25 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | None | $741.31 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $588.84 Median $776.25 Typical High $1,047.13 | Professional | None | $588.84 | $776.25 | $1,047.13 |
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 $323.59 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $95.50 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $371.54 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $147.91 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $562.34 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $112.20 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $74.13 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $524.81 | $549.54 | $549.54 |
Where Maine sits
The same service costs 8.3 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· 32nd of 51
$794
AK $2,570TX $309
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.