How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $7,586Professionalmedian $4,786 · 10th to 90th $3,715 to $7,244
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 $3,801.89 Median $4,786.30 Typical High $4,786.30 | Professional | None | $3,801.89 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,715.35 Median $4,786.30 Typical High $7,244.36 | Professional | None | $3,715.35 | $4,786.30 | $7,244.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $5,495.41 Median $7,244.36 Typical High $10,964.78 | Professional | 50 · Both sides | $5,495.41 | $7,244.36 | $10,964.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $2,344.23 Median $3,019.95 Typical High $4,570.88 | Professional | 62 · Two surgeons | $2,344.23 | $3,019.95 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $588.84 Median $776.25 Typical High $1,174.90 | Professional | 80 · Assistant surgeon | $588.84 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $512.86 Median $676.08 Typical High $1,023.29 | Professional | AS · PA/NP assist | $512.86 | $676.08 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,248.07 Typical High $8,511.38 | Facility | None | $707.95 | $5,248.07 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $3,981.07 Median $5,370.32 Typical High $7,762.47 | Professional | None | $3,981.07 | $5,370.32 | $7,762.47 |
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 $3,715.35 Median $4,265.80 Typical High $6,606.93 | Professional | None | $3,715.35 | $4,265.80 | $6,606.93 |
Martin's Point Setting Professional Modifier None Typical Low $4,466.84 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,786.30 | $4,786.30 |
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 $3,311.31 Median $4,365.16 Typical High $6,025.60 | Professional | None | $3,311.31 | $4,365.16 | $6,025.60 |
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 $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,905.46 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $758.58 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $758.58 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,818.38 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $2,818.38 | $3,630.78 | $3,630.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $562.34 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $562.34 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $380.19 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $380.19 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,630.27 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $2,630.27 | $3,388.44 | $3,388.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,238.72 | $2,398.83 | $2,398.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $891.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $3,388.44 Median $3,630.78 Typical High $3,630.78 | Professional | 54 · Surgery only | $3,388.44 | $3,630.78 | $3,630.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $676.08 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $676.08 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $446.68 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $3,162.28 Median $3,388.44 Typical High $3,388.44 | Professional | 78 · Unplanned return to OR | $3,162.28 | $3,388.44 | $3,388.44 |
Where Maine sits
The same service costs 20.4 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· 24th of 51
$4,786
AK $15,488TX $759
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.