How much rates vary
Facilitymedian $1,778 · 10th to 90th $537 to $3,311Professionalmedian $525 · 10th to 90th $407 to $813
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 $436.52 Median $524.81 Typical High $524.81 | Professional | None | $436.52 | $524.81 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $549.54 Typical High $812.83 | Professional | None | $416.87 | $549.54 | $812.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $831.76 Typical High $1,230.27 | Professional | 50 · Both sides | $630.96 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $346.74 Typical High $512.86 | Professional | 62 · Two surgeons | $263.03 | $346.74 | $512.86 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $87.10 Typical High $131.83 | Professional | 80 · Assistant surgeon | $67.61 | $87.10 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $77.62 Typical High $114.82 | Professional | AS · PA/NP assist | $58.88 | $77.62 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $2,951.21 | Facility | None | $537.03 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $851.14 | Professional | None | $467.74 | $588.84 | $851.14 |
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 $407.38 Median $512.86 Typical High $794.33 | Professional | None | $407.38 | $512.86 | $794.33 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | None | $501.19 | $524.81 | $524.81 |
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 $380.19 Median $512.86 Typical High $707.95 | Professional | None | $380.19 | $512.86 | $707.95 |
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 $218.78 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $218.78 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $87.10 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $323.59 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $64.57 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $43.65 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $302.00 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $251.19 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $100.00 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 54 · Surgery only | $371.54 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $74.13 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $50.12 | $52.48 | $52.48 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $346.74 | $371.54 | $371.54 |
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
$525
AK $1,738TX $209
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.