How much rates vary
Facilitymedian $2,692 · 10th to 90th $708 to $7,586Professionalmedian $1,380 · 10th to 90th $1,072 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 $1,122.02 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,122.02 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,412.54 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $2,137.96 Typical High $3,162.28 | Professional | 50 · Both sides | $1,621.81 | $2,137.96 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $223.87 Typical High $338.84 | Professional | 80 · Assistant surgeon | $173.78 | $223.87 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $199.53 Typical High $295.12 | Professional | AS · PA/NP assist | $151.36 | $199.53 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,248.07 Typical High $8,511.38 | Facility | None | $707.95 | $5,248.07 | $8,511.38 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $2,238.72 | Professional | None | $1,174.90 | $1,548.82 | $2,238.72 |
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 $1,047.13 Median $1,258.93 Typical High $1,995.26 | Professional | None | $1,047.13 | $1,258.93 | $1,995.26 |
Martin's Point Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,288.25 | $1,380.38 | $1,380.38 |
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 $933.25 Median $1,202.26 Typical High $1,737.80 | Professional | None | $933.25 | $1,202.26 | $1,737.80 |
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 $549.54 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $549.54 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $645.65 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $257.04 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,023.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 55 · Aftercare only | $194.98 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $128.82 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $954.99 |
Where Maine sits
The same service costs 13.8 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· 27th of 51
$1,380
AK $4,467TX $324
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.