How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,586Professionalmedian $1,862 · 10th to 90th $1,413 to $2,754
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 $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $2,818.38 | Professional | None | $1,445.44 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $2,818.38 Typical High $4,168.69 | Professional | 50 · Both sides | $2,137.96 | $2,818.38 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,174.90 Typical High $1,778.28 | Professional | 62 · Two surgeons | $891.25 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $295.12 Typical High $446.68 | Professional | 80 · Assistant surgeon | $229.09 | $295.12 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $263.03 Typical High $389.05 | Professional | AS · PA/NP assist | $199.53 | $263.03 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,248.07 Typical High $8,511.38 | Facility | None | $707.95 | $5,248.07 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,041.74 Typical High $2,951.21 | Professional | None | $1,659.59 | $2,041.74 | $2,951.21 |
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 $1,412.54 Median $1,819.70 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,819.70 | $2,570.40 |
Martin's Point Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,445.44 | $1,862.09 | $1,862.09 |
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 $1,412.54 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,819.70 | $2,454.71 |
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 $758.58 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $758.58 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,148.15 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $229.09 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $151.36 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,288.25 | $1,288.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $851.14 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $346.74 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,288.25 | $1,380.38 | $1,380.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $257.04 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $173.78 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,288.25 | $1,288.25 |
Where Maine sits
The same service costs 8.7 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· 31st of 51
$1,862
AK $5,888TX $676
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.