How much rates vary
Facilitymedian $26,915 · 10th to 90th $776 to $27,542Professionalmedian $2,884 · 10th to 90th $2,042 to $3,981
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $21,379.62 Median $26,915.35 Typical High $28,183.83 | Facility | None | $21,379.62 | $26,915.35 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,862.09 Median $2,951.21 Typical High $3,981.07 | Professional | None | $1,862.09 | $2,951.21 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,174.90 Median $1,862.09 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,174.90 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $478.63 Typical High $645.65 | Professional | 80 · Assistant surgeon | $295.12 | $478.63 | $645.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $416.87 Typical High $562.34 | Professional | AS · PA/NP assist | $263.03 | $416.87 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,754.23 Typical High $4,677.35 | Professional | None | $2,570.40 | $2,754.23 | $4,677.35 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,290.87 Median $3,019.95 Typical High $3,981.07 | Professional | None | $2,290.87 | $3,019.95 | $3,981.07 |
Martin's Point Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $3,235.94 Typical High $4,168.69 | Professional | None | $2,187.76 | $3,235.94 | $4,168.69 |
6 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 $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,288.25 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $524.81 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,949.84 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $389.05 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,819.70 | $1,819.70 |
Where Maine sits
The same service costs 22.9 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· 17th of 51
$3,020
AK $8,511TX $372
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.