How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $1,148 · 10th to 90th $912 to $1,778
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $933.25 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,778.28 | Professional | None | $912.01 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $741.31 Typical High $1,122.02 | Professional | 62 · Two surgeons | $575.44 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $190.55 Typical High $288.40 | Professional | 80 · Assistant surgeon | $144.54 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $165.96 Typical High $251.19 | Professional | AS · PA/NP assist | $125.89 | $165.96 | $251.19 |
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 $1,047.13 Median $1,318.26 Typical High $1,949.84 | Professional | None | $1,047.13 | $1,318.26 | $1,949.84 |
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 $870.96 Median $1,122.02 Typical High $1,737.80 | Professional | None | $870.96 | $1,122.02 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,122.02 | $1,148.15 | $1,148.15 |
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 $812.83 Median $1,096.48 Typical High $1,513.56 | Professional | None | $812.83 | $1,096.48 | $1,513.56 |
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 $467.74 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $467.74 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $223.87 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $831.76 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $165.96 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $776.25 | $794.33 | $794.33 |
Where Maine sits
The same service costs 3.1 times more in Alaska than in Hawaii. 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 $8,167HI $2,648
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.