How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,000 to $8,913Professionalmedian $813 · 10th to 90th $631 to $1,259
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 $660.69 Median $812.83 Typical High $1,202.26 | Professional | None | $660.69 | $812.83 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $831.76 Typical High $1,258.93 | Professional | None | $645.65 | $831.76 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,258.93 Typical High $1,862.09 | Professional | 50 · Both sides | $954.99 | $1,258.93 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $524.81 Typical High $794.33 | Professional | 62 · Two surgeons | $407.38 | $524.81 | $794.33 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $134.90 Typical High $199.53 | Professional | 80 · Assistant surgeon | $102.33 | $134.90 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $117.49 Typical High $173.78 | Professional | AS · PA/NP assist | $89.13 | $117.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $9,772.37 | Facility | None | $1,000.00 | $6,165.95 | $9,772.37 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,318.26 | Professional | None | $741.31 | $912.01 | $1,318.26 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,174.90 | Professional | None | $616.60 | $794.33 | $1,174.90 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $1,202.26 | Professional | None | $660.69 | $812.83 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,071.52 | Professional | None | $616.60 | $794.33 | $1,071.52 |
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 $331.13 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $331.13 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $97.72 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $66.07 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $380.19 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $151.36 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $575.44 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $114.82 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $75.86 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $537.03 | $562.34 | $562.34 |
Where Maine sits
The same service costs 5.4 times more in Alaska than in Montana. 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 $11,142MT $2,070
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.