How much rates vary
Facilitymedian $1,259 · 10th to 90th $933 to $3,236Professionalmedian $1,905 · 10th to 90th $1,479 to $2,951
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 $1,548.82 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,548.82 | $1,905.46 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,513.56 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,238.72 Median $2,951.21 Typical High $4,466.84 | Professional | 50 · Both sides | $2,238.72 | $2,951.21 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $239.88 Median $309.03 Typical High $478.63 | Professional | 80 · Assistant surgeon | $239.88 | $309.03 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $208.93 Median $275.42 Typical High $416.87 | Professional | AS · PA/NP assist | $208.93 | $275.42 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,238.72 Typical High $3,235.94 | Facility | None | $1,148.15 | $2,238.72 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,584.89 | $2,187.76 | $3,162.28 |
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 $1,479.11 Median $1,819.70 Typical High $2,818.38 | Professional | None | $1,479.11 | $1,819.70 | $2,818.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,819.70 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,819.70 | $1,905.46 | $1,905.46 |
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 $1,318.26 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,819.70 | $2,511.89 |
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 $776.25 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $776.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $309.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,148.15 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $154.88 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $912.01 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $363.08 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,380.38 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $275.42 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $181.97 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,348.96 | $1,348.96 |
Where Maine sits
The same service costs 15.8 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· 25th of 51
$1,905
AK $6,310TX $398
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.