How much rates vary
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 $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $6,165.95 | Professional | None | $3,019.95 | $4,570.88 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,905.46 Median $2,884.03 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,905.46 | $2,884.03 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $741.31 Typical High $977.24 | Professional | 80 · Assistant surgeon | $489.78 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $645.65 Typical High $851.14 | Professional | AS · PA/NP assist | $426.58 | $645.65 | $851.14 |
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 $3,311.31 Median $4,786.30 Typical High $6,165.95 | Professional | None | $3,311.31 | $4,786.30 | $6,165.95 |
Martin's Point Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
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 $3,235.94 Median $5,128.61 Typical High $6,165.95 | Professional | None | $3,235.94 | $5,128.61 | $6,165.95 |
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 $1,995.26 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,995.26 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $794.33 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $2,951.21 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $398.11 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $2,754.23 | $2,754.23 | $2,754.23 |
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
$4,571
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.