How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $759 · 10th to 90th $589 to $1,175
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 $616.60 Median $758.58 Typical High $758.58 | Professional | None | $616.60 | $758.58 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,174.90 | Professional | None | $602.56 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,174.90 Typical High $1,737.80 | Professional | 50 · Both sides | $891.25 | $1,174.90 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $112.20 Typical High $186.21 | Professional | 80 · Assistant surgeon | $95.50 | $112.20 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | AS · PA/NP assist | $83.18 | $109.65 | $162.18 |
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 $851.14 Typical High $1,288.25 | Professional | None | $691.83 | $851.14 | $1,288.25 |
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 $588.84 Median $741.31 Typical High $1,122.02 | Professional | None | $588.84 | $741.31 | $1,122.02 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $758.58 Typical High $758.58 | Professional | None | $630.96 | $758.58 | $758.58 |
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 $575.44 Median $758.58 Typical High $1,000.00 | Professional | None | $575.44 | $758.58 | $1,000.00 |
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 $309.03 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $63.10 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $354.81 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | 53 · Discontinued | $141.25 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 54 · Surgery only | $537.03 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $107.15 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $70.79 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $501.19 | $524.81 | $524.81 |
Where Maine sits
The same service costs 7.4 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· 35th of 51
$759
AK $2,455TX $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.