How much rates vary
Facilitymedian $2,239 · 10th to 90th $708 to $3,890Professionalmedian $1,585 · 10th to 90th $1,202 to $2,399
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 $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,621.81 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,398.83 Typical High $3,630.78 | Professional | 50 · Both sides | $1,862.09 | $2,398.83 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | 62 · Two surgeons | $776.25 | $1,023.29 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,951.21 | Facility | None | $707.95 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,737.80 Typical High $2,511.89 | Professional | None | $1,202.26 | $1,737.80 | $2,511.89 |
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 $1,230.27 Median $1,584.89 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,584.89 | $2,238.72 |
Martin's Point Setting Professional Modifier None Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,479.11 | $1,584.89 | $1,584.89 |
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 $1,071.52 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,584.89 | $2,137.96 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | 54 · Surgery only | $1,096.48 | $1,202.26 | $1,202.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $218.78 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,023.29 Median $1,122.02 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $1,023.29 | $1,122.02 | $1,122.02 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $9,494KY $2,537
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.