How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $7,586Professionalmedian $1,072 · 10th to 90th $851 to $1,698
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 $1,071.52 Median $1,071.52 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,698.24 | Professional | None | $851.14 | $1,122.02 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $537.03 Median $707.95 Typical High $1,071.52 | Professional | 62 · Two surgeons | $537.03 | $707.95 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $138.04 Median $177.83 Typical High $269.15 | Professional | 80 · Assistant surgeon | $138.04 | $177.83 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $154.88 Typical High $239.88 | Professional | AS · PA/NP assist | $120.23 | $154.88 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $5,248.07 Typical High $8,511.38 | Facility | None | $1,000.00 | $5,248.07 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $1,819.70 | Professional | None | $1,000.00 | $1,258.93 | $1,819.70 |
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 $812.83 Median $1,047.13 Typical High $1,659.59 | Professional | None | $812.83 | $1,047.13 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,659.59 | Professional | None | $1,071.52 | $1,071.52 | $1,659.59 |
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 $794.33 Median $1,023.29 Typical High $1,445.44 | Professional | None | $794.33 | $1,023.29 | $1,445.44 |
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 $446.68 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $446.68 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $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 $89.13 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $758.58 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $524.81 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $208.93 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $794.33 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $158.49 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $104.71 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $741.31 | $758.58 | $758.58 |
Where Maine sits
The same service costs 4.5 times more in Alaska 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
AK $12,963MT $2,892
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.