How much rates vary
Facilitymedian $1,259 · 10th to 90th $537 to $2,692Professionalmedian $832 · 10th to 90th $661 to $1,318
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 $812.83 Typical High $812.83 | Professional | None | $691.83 | $812.83 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,318.26 | Professional | None | $660.69 | $870.96 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $138.04 Typical High $208.93 | Professional | 80 · Assistant surgeon | $104.71 | $138.04 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $93.33 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $93.33 | $120.23 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,819.70 Typical High $2,951.21 | Facility | None | $537.03 | $1,819.70 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,412.54 | Professional | None | $776.25 | $977.24 | $1,412.54 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $1,318.26 | Professional | None | $616.60 | $831.76 | $1,318.26 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $1,071.52 | Professional | None | $575.44 | $776.25 | $1,071.52 |
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 $346.74 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $346.74 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $138.04 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $512.86 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $102.33 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $478.63 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $407.38 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $162.18 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $616.60 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $575.44 |
Where Maine sits
The same service costs 7.8 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· 29th of 51
$832
AK $2,754TX $355
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.