How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $6,310Professionalmedian $661 · 10th to 90th $525 to $1,023
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 $549.54 Median $660.69 Typical High $660.69 | Professional | None | $549.54 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | None | $524.81 | $676.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | 80 · Assistant surgeon | $83.18 | $109.65 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $95.50 Typical High $144.54 | Professional | AS · PA/NP assist | $72.44 | $95.50 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,862.09 Typical High $2,951.21 | Facility | None | $707.95 | $1,862.09 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,202.26 | Professional | None | $602.56 | $741.31 | $1,202.26 |
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 $524.81 Median $660.69 Typical High $954.99 | Professional | None | $524.81 | $660.69 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | None | $630.96 | $660.69 | $660.69 |
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 $512.86 Median $691.83 Typical High $954.99 | Professional | None | $512.86 | $691.83 | $954.99 |
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 $275.42 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $275.42 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $112.20 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $416.87 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $83.18 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $309.03 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $309.03 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $125.89 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $467.74 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $93.33 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $436.52 | $467.74 | $467.74 |
Where Maine sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 35th of 51
$692
AK $2,188UT $331
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.