How much rates vary
Facilitymedian $26,915 · 10th to 90th $776 to $27,542Professionalmedian $3,631 · 10th to 90th $2,754 to $5,495
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 $2,951.21 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,951.21 | $3,388.44 | $3,388.44 |
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 $2,754.23 Median $3,715.35 Typical High $5,754.40 | Professional | None | $2,754.23 | $3,715.35 | $5,754.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,737.80 Median $2,238.72 Typical High $3,388.44 | Professional | 62 · Two surgeons | $1,737.80 | $2,238.72 | $3,388.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $436.52 Median $562.34 Typical High $851.14 | Professional | 80 · Assistant surgeon | $436.52 | $562.34 | $851.14 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $380.19 Median $489.78 Typical High $758.58 | Professional | AS · PA/NP assist | $380.19 | $489.78 | $758.58 |
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 $2,818.38 Median $4,073.80 Typical High $6,025.60 | Professional | None | $2,818.38 | $4,073.80 | $6,025.60 |
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 $2,818.38 Median $3,801.89 Typical High $5,495.41 | Professional | None | $2,818.38 | $3,801.89 | $5,495.41 |
Martin's Point Setting Professional Modifier None Typical Low $3,235.94 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,235.94 | $3,388.44 | $3,388.44 |
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 $2,754.23 Median $3,981.07 Typical High $5,495.41 | Professional | None | $2,754.23 | $3,981.07 | $5,495.41 |
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 $1,479.11 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,479.11 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $588.84 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,238.72 Median $2,511.89 Typical High $2,570.40 | Professional | 54 · Surgery only | $2,238.72 | $2,511.89 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $446.68 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,089.30 Median $2,344.23 Typical High $2,398.83 | Professional | 78 · Unplanned return to OR | $2,089.30 | $2,344.23 | $2,398.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,621.81 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,621.81 | $1,698.24 | $1,698.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $645.65 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $645.65 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $2,454.71 | $2,511.89 | $2,511.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $489.78 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $489.78 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $323.59 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,290.87 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $2,290.87 | $2,344.23 | $2,344.23 |
Where Maine sits
The same service costs 5.1 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· 21st of 51
$3,802
AK $9,772TX $1,905
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.