How much rates vary
Facilitymedian $1,862 · 10th to 90th $708 to $6,026Professionalmedian $603 · 10th to 90th $468 to $912
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 $489.78 Median $602.56 Typical High $891.25 | Professional | None | $489.78 | $602.56 | $891.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $912.01 | Professional | None | $467.74 | $602.56 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $295.12 Median $380.19 Typical High $575.44 | Professional | 62 · Two surgeons | $295.12 | $380.19 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $74.13 Median $97.72 Typical High $144.54 | Professional | 80 · Assistant surgeon | $74.13 | $97.72 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $64.57 Median $85.11 Typical High $128.82 | Professional | AS · PA/NP assist | $64.57 | $85.11 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $1,000.00 | Professional | None | $537.03 | $660.69 | $1,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $870.96 | Professional | None | $467.74 | $602.56 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $891.25 | Professional | None | $501.19 | $602.56 | $891.25 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $812.83 | Professional | None | $457.09 | $602.56 | $812.83 |
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 $245.47 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $338.84 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $281.84 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $112.20 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $446.68 Typical High $446.68 | Professional | 54 · Surgery only | $416.87 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $83.18 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $56.23 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $389.05 | $416.87 | $416.87 |
Where Maine sits
The same service costs 7.0 times more in Alabama 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
AL $10,808MT $1,535
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.