How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $15,849Professionalmedian $1,585 · 10th to 90th $1,202 to $2,399
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 $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,230.27 | $1,621.81 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,454.71 Typical High $3,630.78 | Professional | 50 · Both sides | $1,862.09 | $2,454.71 | $3,630.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | 62 · Two surgeons | $776.25 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $257.04 Typical High $389.05 | Professional | 80 · Assistant surgeon | $199.53 | $257.04 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $229.09 Typical High $338.84 | Professional | AS · PA/NP assist | $173.78 | $229.09 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,715.19 Typical High $17,378.01 | Facility | None | $1,000.00 | $10,715.19 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,737.80 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,737.80 | $2,570.40 |
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 $1,202.26 Median $1,548.82 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,548.82 | $2,290.87 |
Martin's Point Setting Professional Modifier None Typical Low $1,318.26 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,584.89 | $1,584.89 |
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 $1,202.26 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,202.26 | $1,548.82 | $2,089.30 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $954.99 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $891.25 | $1,096.48 | $1,096.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $741.31 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $223.87 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $147.91 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
Where Maine sits
The same service costs 7.6 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
$1,585
AK $5,129TX $676
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.