How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,586Professionalmedian $2,138 · 10th to 90th $1,660 to $3,236
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 $1,778.28 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,778.28 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,659.59 Median $2,187.76 Typical High $3,235.94 | Professional | None | $1,659.59 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,511.89 Median $3,235.94 Typical High $4,897.79 | Professional | 50 · Both sides | $2,511.89 | $3,235.94 | $4,897.79 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,380.38 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,047.13 | $1,380.38 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $346.74 Typical High $524.81 | Professional | 80 · Assistant surgeon | $269.15 | $346.74 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $302.00 Typical High $457.09 | Professional | AS · PA/NP assist | $234.42 | $302.00 | $457.09 |
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 $1,905.46 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,905.46 | $2,344.23 | $3,388.44 |
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 $1,659.59 Median $2,137.96 Typical High $2,951.21 | Professional | None | $1,659.59 | $2,137.96 | $2,951.21 |
Martin's Point Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,778.28 | $2,137.96 | $2,137.96 |
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 $1,621.81 Median $2,137.96 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,137.96 | $2,884.03 |
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 $891.25 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $891.25 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $354.81 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,318.26 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $177.83 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $1,000.00 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $426.58 Typical High $426.58 | Professional | 53 · Discontinued | $398.11 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $1,513.56 | $1,621.81 | $1,621.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $302.00 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $199.53 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,513.56 | $1,513.56 |
Where Maine sits
The same service costs 9.3 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
$2,138
AK $6,918TX $741
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.