How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,586Professionalmedian $1,995 · 10th to 90th $1,549 to $3,020
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 $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,584.89 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,019.95 | Professional | None | $1,548.82 | $1,995.26 | $3,019.95 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,290.87 Median $3,019.95 Typical High $4,570.88 | Professional | 50 · Both sides | $2,290.87 | $3,019.95 | $4,570.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | 62 · Two surgeons | $977.24 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $245.47 Median $323.59 Typical High $478.63 | Professional | 80 · Assistant surgeon | $245.47 | $323.59 | $478.63 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $213.80 Median $281.84 Typical High $426.58 | Professional | AS · PA/NP assist | $213.80 | $281.84 | $426.58 |
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 $2,187.76 Typical High $3,162.28 | Professional | None | $1,659.59 | $2,187.76 | $3,162.28 |
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 $1,548.82 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,548.82 | $1,995.26 | $2,754.23 |
Martin's Point Setting Professional Modifier None Typical Low $1,621.81 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,621.81 | $1,995.26 | $1,995.26 |
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 $1,995.26 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,995.26 | $2,691.53 |
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 $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $812.83 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,412.54 | $1,412.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $933.25 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $371.54 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,380.38 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,380.38 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $281.84 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $186.21 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,288.25 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,288.25 | $1,412.54 | $1,412.54 |
Where Maine sits
The same service costs 8.9 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· 28th of 51
$1,995
AK $6,457TX $724
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.