How much rates vary
Facilitymedian $2,291 · 10th to 90th $813 to $3,890Professionalmedian $1,072 · 10th to 90th $832 to $1,622
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 $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | None | $870.96 | $1,071.52 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,659.59 | Professional | None | $831.76 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,659.59 Typical High $2,454.71 | Professional | 50 · Both sides | $1,258.93 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $691.83 Typical High $1,023.29 | Professional | 62 · Two surgeons | $524.81 | $691.83 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $173.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $134.90 | $173.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $117.49 Median $154.88 Typical High $229.09 | Professional | AS · PA/NP assist | $117.49 | $154.88 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,344.23 Typical High $3,715.35 | Facility | None | $812.83 | $2,344.23 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,202.26 Typical High $1,737.80 | Professional | None | $977.24 | $1,202.26 | $1,737.80 |
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 $831.76 Median $1,047.13 Typical High $1,513.56 | Professional | None | $831.76 | $1,047.13 | $1,513.56 |
Martin's Point Setting Professional Modifier None Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,000.00 | $1,071.52 | $1,071.52 |
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 $812.83 Median $1,047.13 Typical High $1,412.54 | Professional | None | $812.83 | $1,047.13 | $1,412.54 |
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 $436.52 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $602.56 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $501.19 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $199.53 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $758.58 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $151.36 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $100.00 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $758.58 |
Where Maine sits
The same service costs 7.9 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
$1,072
AK $3,467TX $437
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.