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 $2,884.03 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,884.03 | $3,235.94 | $3,235.94 |
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 $2,818.38 Median $3,890.45 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,890.45 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,778.28 Median $2,290.87 Typical High $3,467.37 | Professional | 62 · Two surgeons | $1,778.28 | $2,290.87 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $588.84 Typical High $891.25 | Professional | 80 · Assistant surgeon | $446.68 | $588.84 | $891.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $398.11 Median $512.86 Typical High $776.25 | Professional | AS · PA/NP assist | $398.11 | $512.86 | $776.25 |
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 $3,162.28 Median $4,168.69 Typical High $6,309.57 | Professional | None | $3,162.28 | $4,168.69 | $6,309.57 |
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 $2,691.53 Median $3,715.35 Typical High $5,495.41 | Professional | None | $2,691.53 | $3,715.35 | $5,495.41 |
Martin's Point Setting Professional Modifier None Typical Low $3,090.30 Median $3,235.94 Typical High $3,235.94 | Professional | None | $3,090.30 | $3,235.94 | $3,235.94 |
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 $2,630.27 Median $3,715.35 Typical High $5,623.41 | Professional | None | $2,630.27 | $3,715.35 | $5,623.41 |
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 $1,445.44 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,445.44 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $575.44 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,187.76 | $2,454.71 | $2,454.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $288.40 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,290.87 | $2,290.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,621.81 Typical High $1,621.81 | Professional | 52 · Reduced service | $1,548.82 | $1,621.81 | $1,621.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 53 · Discontinued | $630.96 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,454.71 Typical High $2,454.71 | Professional | 54 · Surgery only | $2,344.23 | $2,454.71 | $2,454.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 55 · Aftercare only | $467.74 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,290.87 Typical High $2,290.87 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,290.87 | $2,290.87 |
Where Maine sits
The same service costs 21.4 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· 22nd of 51
$3,802
AK $9,772TX $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.