How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,000 to $10,715Professionalmedian $977 · 10th to 90th $759 to $1,514
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 $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,513.56 | Professional | None | $776.25 | $1,000.00 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,148.15 Median $1,513.56 Typical High $2,238.72 | Professional | 50 · Both sides | $1,148.15 | $1,513.56 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $489.78 Median $630.96 Typical High $954.99 | Professional | 62 · Two surgeons | $489.78 | $630.96 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $162.18 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $141.25 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $141.25 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $6,918.31 Typical High $9,332.54 | Facility | None | $1,000.00 | $6,918.31 | $9,332.54 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,584.89 | Professional | None | $891.25 | $1,096.48 | $1,584.89 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $10,715.19 | Facility | None | $2,137.96 | $2,691.53 | $10,715.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,412.54 | Professional | None | $758.58 | $977.24 | $1,412.54 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | None | $776.25 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $10,715.19 | Facility | None | $2,137.96 | $2,691.53 | $10,715.19 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $1,318.26 | Professional | None | $758.58 | $977.24 | $1,318.26 |
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 $407.38 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $407.38 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $457.09 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $186.21 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $691.83 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $138.04 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $93.33 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $645.65 | $691.83 | $691.83 |
Where Maine sits
The same service costs 5.9 times more in Alaska 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
AK $14,644MT $2,489
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.