How much rates vary
Facilitymedian $2,512 · 10th to 90th $813 to $7,762Professionalmedian $851 · 10th to 90th $676 to $1,288
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 $691.83 Median $851.14 Typical High $851.14 | Professional | None | $691.83 | $851.14 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,318.26 | Professional | None | $676.08 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,318.26 Typical High $1,949.84 | Professional | 50 · Both sides | $1,000.00 | $1,318.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $107.15 | $138.04 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $123.03 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $123.03 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $5,370.32 Typical High $8,511.38 | Facility | None | $812.83 | $5,370.32 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $954.99 Typical High $1,445.44 | Professional | None | $776.25 | $954.99 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $676.08 Median $831.76 Typical High $1,202.26 | Professional | None | $676.08 | $831.76 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | None | $707.95 | $851.14 | $851.14 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $645.65 Median $870.96 Typical High $1,122.02 | Professional | None | $645.65 | $870.96 | $1,122.02 |
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 $354.81 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $524.81 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $70.79 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $398.11 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $158.49 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $602.56 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $562.34 | $602.56 | $602.56 |
Where Maine sits
The same service costs 6.4 times more in Colorado than in Montana. 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
CO $13,837MT $2,168
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.