How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,148 to $11,220Professionalmedian $1,259 · 10th to 90th $977 to $1,905
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 $1,000.00 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,000.00 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $1,949.84 | Professional | None | $977.24 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,949.84 Typical High $2,884.03 | Professional | 50 · Both sides | $1,479.11 | $1,949.84 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $204.17 Typical High $309.03 | Professional | 80 · Assistant surgeon | $158.49 | $204.17 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $181.97 Typical High $269.15 | Professional | AS · PA/NP assist | $138.04 | $181.97 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $7,585.78 Typical High $12,302.69 | Facility | None | $1,148.15 | $7,585.78 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,148.15 | $1,412.54 | $2,041.74 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,778.28 | Professional | None | $977.24 | $1,230.27 | $1,778.28 |
Martin's Point Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,174.90 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,659.59 | Professional | None | $933.25 | $1,230.27 | $1,659.59 |
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 $501.19 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $501.19 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $204.17 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $758.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $100.00 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $707.95 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $588.84 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $588.84 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | 53 · Discontinued | $234.42 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 54 · Surgery only | $891.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $177.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $117.49 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $891.25 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $831.76 | $891.25 | $891.25 |
Where Maine sits
The same service costs 8.5 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
$1,259
AK $4,074TX $479
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.