How much rates vary
Facilitymedian $2,754 · 10th to 90th $708 to $8,913Professionalmedian $1,413 · 10th to 90th $1,096 to $2,138
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 $1,174.90 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,412.54 | $2,041.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,187.76 | Professional | None | $1,096.48 | $1,445.44 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,659.59 Median $2,187.76 Typical High $3,235.94 | Professional | 50 · Both sides | $1,659.59 | $2,187.76 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $912.01 Typical High $1,380.38 | Professional | 62 · Two surgeons | $691.83 | $912.01 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $229.09 Typical High $346.74 | Professional | 80 · Assistant surgeon | $177.83 | $229.09 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | AS · PA/NP assist | $154.88 | $204.17 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $6,760.83 Typical High $8,912.51 | Facility | None | $707.95 | $6,760.83 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,584.89 | $2,290.87 |
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 $1,096.48 Median $1,412.54 Typical High $1,995.26 | Professional | None | $1,096.48 | $1,412.54 | $1,995.26 |
Martin's Point Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,174.90 | $1,412.54 | $2,041.74 |
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 $1,071.52 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,412.54 | $1,905.46 |
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 $588.84 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $234.42 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $870.96 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $173.78 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $117.49 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $812.83 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $707.95 Typical High $707.95 | Professional | 52 · Reduced service | $660.69 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $281.84 Typical High $281.84 | Professional | 53 · Discontinued | $269.15 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,000.00 Median $1,071.52 Typical High $1,071.52 | Professional | 54 · Surgery only | $1,000.00 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $199.53 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $141.25 Typical High $141.25 | Professional | 56 · Pre-op care only | $131.83 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $933.25 | $1,000.00 | $1,000.00 |
Where Maine sits
The same service costs 5.1 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 $14,343KY $2,808
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.