How much rates vary
Facilitymedian $2,692 · 10th to 90th $2,138 to $7,079Professionalmedian $1,122 · 10th to 90th $871 to $1,738
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | None | $912.01 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,737.80 | Professional | None | $891.25 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,318.26 Median $1,737.80 Typical High $2,570.40 | Professional | 50 · Both sides | $1,318.26 | $1,737.80 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $562.34 Median $724.44 Typical High $1,096.48 | Professional | 62 · Two surgeons | $562.34 | $724.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $186.21 Typical High $275.42 | Professional | 80 · Assistant surgeon | $141.25 | $186.21 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $162.18 Typical High $239.88 | Professional | AS · PA/NP assist | $123.03 | $162.18 | $239.88 |
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 $870.96 Median $1,122.02 Typical High $1,621.81 | Professional | None | $870.96 | $1,122.02 | $1,621.81 |
Martin's Point Setting Professional Modifier None Typical Low $1,047.13 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,047.13 | $1,122.02 | $1,122.02 |
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 $851.14 Median $1,122.02 Typical High $1,513.56 | Professional | None | $851.14 | $1,122.02 | $1,513.56 |
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 $457.09 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $186.21 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $524.81 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $524.81 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $208.93 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $851.14 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $104.71 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $794.33 | $794.33 |
Where Maine sits
The same service costs 16.6 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· 32nd of 51
$1,122
AK $3,631TX $219
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.