How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,079Professionalmedian $2,570 · 10th to 90th $1,995 to $3,890
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 $2,137.96 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,137.96 | $2,570.40 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,630.27 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $3,019.95 Median $3,890.45 Typical High $5,888.44 | Professional | 50 · Both sides | $3,019.95 | $3,890.45 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,258.93 Median $1,659.59 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,258.93 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $416.87 Typical High $630.96 | Professional | 80 · Assistant surgeon | $316.23 | $416.87 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $281.84 Median $363.08 Typical High $549.54 | Professional | AS · PA/NP assist | $281.84 | $363.08 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,818.38 Typical High $4,073.80 | Professional | None | $1,949.84 | $2,818.38 | $4,073.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,995.26 Median $2,570.40 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,570.40 | $3,548.13 |
Martin's Point Setting Professional Modifier None Typical Low $2,398.83 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,398.83 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,570.40 Typical High $3,467.37 | Professional | None | $1,778.28 | $2,570.40 | $3,467.37 |
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 $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,071.52 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $426.58 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $213.80 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,819.70 | $1,819.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,202.26 | $1,288.25 | $1,288.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $478.63 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,819.70 | $1,949.84 | $1,949.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $363.08 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $239.88 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,819.70 | $1,819.70 |
Where Maine sits
The same service costs 4.9 times more in Alaska than in Kentucky. 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 $18,090KY $3,723
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.