How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $7,943Professionalmedian $2,089 · 10th to 90th $1,622 to $3,162
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 $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,089.30 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,398.83 Median $3,162.28 Typical High $4,677.35 | Professional | 50 · Both sides | $2,398.83 | $3,162.28 | $4,677.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,318.26 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,023.29 | $1,318.26 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $257.04 Median $338.84 Typical High $501.19 | Professional | 80 · Assistant surgeon | $257.04 | $338.84 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $223.87 Median $295.12 Typical High $436.52 | Professional | AS · PA/NP assist | $223.87 | $295.12 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,495.41 Typical High $8,709.64 | Facility | None | $707.95 | $5,495.41 | $8,709.64 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $3,311.31 | Professional | None | $1,862.09 | $2,290.87 | $3,311.31 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,621.81 | $2,089.30 | $2,884.03 |
Martin's Point Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,089.30 | $2,818.38 |
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 $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $851.14 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $338.84 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,288.25 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,288.25 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $257.04 | $309.03 | $309.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $169.82 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,202.26 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,047.13 Typical High $1,047.13 | Professional | 52 · Reduced service | $977.24 | $1,047.13 | $1,047.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 53 · Discontinued | $389.05 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,548.82 Typical High $1,548.82 | Professional | 54 · Surgery only | $1,445.44 | $1,548.82 | $1,548.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $309.03 Typical High $309.03 | Professional | 55 · Aftercare only | $288.40 | $309.03 | $309.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,445.44 Typical High $1,445.44 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,445.44 | $1,445.44 |
Where Maine sits
The same service costs 4.7 times more in Alaska than in Kentucky. 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.
Physician feeFacility fee
AK $16,761KY $3,604
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.