How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,698 to $5,754Professionalmedian $1,148 · 10th to 90th $891 to $1,778
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 $933.25 Median $1,148.15 Typical High $1,148.15 | Professional | None | $933.25 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,778.28 | Professional | None | $912.01 | $1,174.90 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,778.28 Typical High $2,630.27 | Professional | 50 · Both sides | $1,348.96 | $1,778.28 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $190.55 Typical High $281.84 | Professional | 80 · Assistant surgeon | $144.54 | $190.55 | $281.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $165.96 Typical High $245.47 | Professional | AS · PA/NP assist | $125.89 | $165.96 | $245.47 |
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 $891.25 Median $1,122.02 Typical High $1,659.59 | Professional | None | $891.25 | $1,122.02 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | None | $1,071.52 | $1,148.15 | $1,148.15 |
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 $851.14 Median $1,122.02 Typical High $1,513.56 | Professional | None | $851.14 | $1,122.02 | $1,513.56 |
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 $467.74 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $691.83 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $537.03 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $213.80 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $812.83 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $162.18 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $107.15 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $758.58 | $812.83 | $812.83 |
Where Maine sits
The same service costs 17.4 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· 30th of 51
$1,148
AK $3,715TX $214
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.