How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $776 · 10th to 90th $603 to $1,202
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 $630.96 Median $776.25 Typical High $776.25 | Professional | None | $630.96 | $776.25 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $812.83 Typical High $1,202.26 | Professional | None | $616.60 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,202.26 Typical High $1,819.70 | Professional | 50 · Both sides | $933.25 | $1,202.26 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $512.86 Typical High $758.58 | Professional | 62 · Two surgeons | $389.05 | $512.86 | $758.58 |
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 $112.20 Typical High $169.82 | Professional | AS · PA/NP assist | $87.10 | $112.20 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,238.72 Typical High $2,951.21 | Facility | None | $812.83 | $2,238.72 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $1,258.93 | Professional | None | $691.83 | $870.96 | $1,258.93 |
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 $602.56 Median $758.58 Typical High $1,148.15 | Professional | None | $602.56 | $758.58 | $1,148.15 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $776.25 Typical High $776.25 | Professional | None | $741.31 | $776.25 | $776.25 |
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 $562.34 Median $758.58 Typical High $1,047.13 | Professional | None | $562.34 | $758.58 | $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 $316.23 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $316.23 | $389.05 | $389.05 |
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 $63.10 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $77.62 |
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 $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $371.54 | $389.05 | $389.05 |
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 $549.54 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $549.54 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $109.65 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $74.13 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $512.86 | $549.54 | $549.54 |
Where Maine sits
The same service costs 7.8 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
$776
AK $2,570TX $331
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.