How much rates vary
Facilitymedian $2,239 · 10th to 90th $813 to $3,890Professionalmedian $1,023 · 10th to 90th $832 to $1,622
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 $851.14 Median $1,023.29 Typical High $1,023.29 | Professional | None | $851.14 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,621.81 | Professional | None | $831.76 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $524.81 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $524.81 | $724.44 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $186.21 Typical High $263.03 | Professional | 80 · Assistant surgeon | $131.83 | $186.21 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $162.18 Typical High $229.09 | Professional | AS · PA/NP assist | $114.82 | $162.18 | $229.09 |
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 $954.99 Median $1,202.26 Typical High $1,737.80 | Professional | None | $954.99 | $1,202.26 | $1,737.80 |
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 $776.25 Median $1,023.29 Typical High $1,584.89 | Professional | None | $776.25 | $1,023.29 | $1,584.89 |
Martin's Point Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
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 $741.31 Median $1,000.00 Typical High $1,380.38 | Professional | None | $741.31 | $1,000.00 | $1,380.38 |
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 $426.58 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $426.58 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $169.82 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $85.11 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $501.19 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $501.19 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $204.17 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | 54 · Surgery only | $758.58 | $776.25 | $776.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $151.36 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $724.44 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $707.95 | $724.44 | $724.44 |
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· 30th of 51
$1,023
AK $3,467TX $468
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.