How much rates vary
Facilitymedian $2,512 · 10th to 90th $1,585 to $5,754Professionalmedian $891 · 10th to 90th $692 to $1,349
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 $758.58 Median $870.96 Typical High $870.96 | Professional | None | $758.58 | $870.96 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $933.25 Typical High $1,445.44 | Professional | None | $691.83 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $141.25 Typical High $213.80 | Professional | 80 · Assistant surgeon | $109.65 | $141.25 | $213.80 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $123.03 Typical High $186.21 | Professional | AS · PA/NP assist | $95.50 | $123.03 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $4,073.80 Typical High $5,495.41 | Facility | None | $1,584.89 | $4,073.80 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $912.01 Typical High $1,548.82 | Professional | None | $758.58 | $912.01 | $1,548.82 |
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 $707.95 Median $933.25 Typical High $1,348.96 | Professional | None | $707.95 | $933.25 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | None | $758.58 | $870.96 | $870.96 |
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 $691.83 Median $933.25 Typical High $1,412.54 | Professional | None | $691.83 | $933.25 | $1,412.54 |
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 $380.19 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $151.36 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $562.34 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $380.19 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $154.88 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 54 · Surgery only | $575.44 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $602.56 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $602.56 |
Where Maine sits
The same service costs 6.3 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· 26th of 51
$912
AK $2,884TX $457
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.