How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $14,454Professionalmedian $1,622 · 10th to 90th $1,259 to $2,512
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 $1,621.81 Typical High $1,621.81 | Professional | None | $1,318.26 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,511.89 | Professional | None | $1,258.93 | $1,659.59 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,905.46 Median $2,511.89 Typical High $3,715.35 | Professional | 50 · Both sides | $1,905.46 | $2,511.89 | $3,715.35 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $794.33 Median $1,047.13 Typical High $1,584.89 | Professional | 62 · Two surgeons | $794.33 | $1,047.13 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $204.17 Median $263.03 Typical High $398.11 | Professional | 80 · Assistant surgeon | $204.17 | $263.03 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $177.83 Median $234.42 Typical High $346.74 | Professional | AS · PA/NP assist | $177.83 | $234.42 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $10,000.00 Typical High $15,848.93 | Facility | None | $1,000.00 | $10,000.00 | $15,848.93 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,412.54 | $1,819.70 | $2,630.27 |
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 $1,230.27 Median $1,548.82 Typical High $2,344.23 | Professional | None | $1,230.27 | $1,548.82 | $2,344.23 |
Martin's Point Setting Professional Modifier None Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,548.82 | $1,621.81 | $1,621.81 |
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 $1,174.90 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,174.90 | $1,548.82 | $2,137.96 |
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 $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $645.65 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $263.03 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $977.24 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $194.98 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $131.83 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $912.01 | $1,148.15 | $1,148.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $776.25 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,148.15 | $1,230.27 | $1,230.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $229.09 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $229.09 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $154.88 | $162.18 | $162.18 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,071.52 | $1,148.15 | $1,148.15 |
Where Maine sits
The same service costs 7.4 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
$1,622
AK $5,248TX $708
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.