How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,148 to $7,079Professionalmedian $1,000 · 10th to 90th $741 to $1,479
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 $776.25 Median $912.01 Typical High $912.01 | Professional | None | $776.25 | $912.01 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,584.89 | Professional | None | $741.31 | $1,023.29 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $457.09 Median $616.60 Typical High $933.25 | Professional | 62 · Two surgeons | $457.09 | $616.60 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $117.49 Median $154.88 Typical High $234.42 | Professional | 80 · Assistant surgeon | $117.49 | $154.88 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $134.90 Typical High $204.17 | Professional | AS · PA/NP assist | $102.33 | $134.90 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $1,698.24 | Professional | None | $851.14 | $1,096.48 | $1,698.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $776.25 Median $1,047.13 Typical High $1,479.11 | Professional | None | $776.25 | $1,047.13 | $1,479.11 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $741.31 Median $1,071.52 Typical High $1,513.56 | Professional | None | $741.31 | $1,071.52 | $1,513.56 |
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 $389.05 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $389.05 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $154.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $575.44 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $114.82 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $537.03 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $177.83 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $691.83 Typical High $691.83 | Professional | 54 · Surgery only | $676.08 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $645.65 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $630.96 | $645.65 | $645.65 |
Where Maine sits
The same service costs 25.1 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· 25th of 51
$1,000
AK $3,090TX $123
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.