How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,148 to $3,890Professionalmedian $1,202 · 10th to 90th $955 to $1,862
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 $1,000.00 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,000.00 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,288.25 Typical High $1,949.84 | Professional | None | $933.25 | $1,288.25 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $194.98 Typical High $295.12 | Professional | 80 · Assistant surgeon | $151.36 | $194.98 | $295.12 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $169.82 Typical High $257.04 | Professional | AS · PA/NP assist | $131.83 | $169.82 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $3,235.94 | Facility | None | $1,148.15 | $1,995.26 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,137.96 | Professional | None | $1,000.00 | $1,258.93 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,778.28 | Professional | None | $954.99 | $1,230.27 | $1,778.28 |
Martin's Point Setting Professional Modifier None Typical Low $1,023.29 Median $1,174.90 Typical High $1,174.90 | Professional | None | $1,023.29 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,905.46 | Professional | None | $933.25 | $1,258.93 | $1,905.46 |
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 $501.19 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $501.19 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $199.53 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $512.86 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $776.25 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $154.88 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $102.33 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $724.44 | $831.76 | $831.76 |
Where Maine sits
The same service costs 6.2 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· 23rd of 51
$1,230
AK $3,802TX $617
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.