How much rates vary
Facilitymedian $1,259 · 10th to 90th $813 to $2,291Professionalmedian $1,698 · 10th to 90th $1,288 to $2,692
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 $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,754.23 | Professional | None | $1,380.38 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,089.30 Median $2,754.23 Typical High $4,073.80 | Professional | 50 · Both sides | $2,089.30 | $2,754.23 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,148.15 Typical High $1,698.24 | Professional | 62 · Two surgeons | $870.96 | $1,148.15 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $288.40 Typical High $436.52 | Professional | 80 · Assistant surgeon | $223.87 | $288.40 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $257.04 Typical High $380.19 | Professional | AS · PA/NP assist | $194.98 | $257.04 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,698.24 Typical High $2,290.87 | Facility | None | $812.83 | $1,698.24 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,288.25 | $1,862.09 | $2,691.53 |
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 $1,288.25 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,698.24 | $2,511.89 |
Martin's Point Setting Professional Modifier None Typical Low $1,584.89 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,584.89 | $1,659.59 | $1,659.59 |
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 $1,148.15 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,698.24 | $2,290.87 |
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 $707.95 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $707.95 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $281.84 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $141.25 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,174.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $794.33 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $316.23 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,258.93 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,174.90 | $1,258.93 | $1,258.93 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $239.88 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $158.49 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,174.90 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,174.90 | $1,174.90 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Delaware. 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 $8,917DE $2,410
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.