How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $2,692Professionalmedian $977 · 10th to 90th $794 to $1,585
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 $831.76 Median $977.24 Typical High $977.24 | Professional | None | $831.76 | $977.24 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $1,047.13 Typical High $1,584.89 | Professional | None | $794.33 | $1,047.13 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $128.82 Median $165.96 Typical High $251.19 | Professional | 80 · Assistant surgeon | $128.82 | $165.96 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $112.20 Median $147.91 Typical High $223.87 | Professional | AS · PA/NP assist | $112.20 | $147.91 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,951.21 | Facility | None | $707.95 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,174.90 Typical High $1,698.24 | Professional | None | $870.96 | $1,174.90 | $1,698.24 |
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 $758.58 Median $977.24 Typical High $1,548.82 | Professional | None | $758.58 | $977.24 | $1,548.82 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $707.95 Median $954.99 Typical High $1,318.26 | Professional | None | $707.95 | $954.99 | $1,318.26 |
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 $416.87 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $416.87 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $165.96 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $616.60 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $194.98 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
Where Maine sits
The same service costs 8.3 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
$977
AK $3,388TX $407
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.