How much rates vary
Facilitymedian $1,905 · 10th to 90th $1,000 to $4,898Professionalmedian $977 · 10th to 90th $708 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 $794.33 Median $851.14 Typical High $1,000.00 | Professional | None | $794.33 | $851.14 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $977.24 Typical High $1,621.81 | Professional | None | $660.69 | $977.24 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $158.49 Typical High $257.04 | Professional | 80 · Assistant surgeon | $104.71 | $158.49 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $138.04 Typical High $229.09 | Professional | AS · PA/NP assist | $91.20 | $138.04 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,000.00 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,122.02 Typical High $1,659.59 | Professional | None | $794.33 | $1,122.02 | $1,659.59 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $724.44 Median $1,047.13 Typical High $1,659.59 | Professional | None | $724.44 | $1,047.13 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,000.00 | Professional | None | $794.33 | $851.14 | $1,000.00 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $676.08 Median $977.24 Typical High $1,479.11 | Professional | None | $676.08 | $977.24 | $1,479.11 |
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 $398.11 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $758.58 | Professional | 54 · Surgery only | $588.84 | $645.65 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $128.82 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $707.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $426.58 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $426.58 | $501.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $169.82 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $169.82 | $199.53 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $630.96 Typical High $758.58 | Professional | 54 · Surgery only | $602.56 | $630.96 | $758.58 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $125.89 Typical High $151.36 | Professional | 55 · Aftercare only | $120.23 | $125.89 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $85.11 Typical High $100.00 | Professional | 56 · Pre-op care only | $79.43 | $85.11 | $100.00 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $588.84 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $562.34 | $588.84 | $707.95 |
Where Maine sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 24th of 51
$977
AK $2,754NJ $631
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.