How much rates vary
Facilitymedian $16,218 · 10th to 90th $813 to $16,596Professionalmedian $316 · 10th to 90th $240 to $468
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 $245.47 Median $288.40 Typical High $295.12 | Professional | None | $245.47 | $288.40 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $16,218.10 Typical High $16,982.44 | Facility | None | $12,589.25 | $16,218.10 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $489.78 | Professional | None | $234.42 | $323.59 | $489.78 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $147.91 Median $190.55 Typical High $288.40 | Professional | 62 · Two surgeons | $147.91 | $190.55 | $288.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $37.15 Median $48.98 Typical High $74.13 | Professional | 80 · Assistant surgeon | $37.15 | $48.98 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $42.66 Typical High $64.57 | Professional | AS · PA/NP assist | $32.36 | $42.66 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $524.81 | Professional | None | $309.03 | $346.74 | $524.81 |
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 $239.88 Median $316.23 Typical High $446.68 | Professional | None | $239.88 | $316.23 | $446.68 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | None | $275.42 | $288.40 | $288.40 |
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 $239.88 Median $338.84 Typical High $467.74 | Professional | None | $239.88 | $338.84 | $467.74 |
10 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 $123.03 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $123.03 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $57.54 Typical High $58.88 | Professional | 53 · Discontinued | $48.98 | $57.54 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $186.21 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $24.55 | $28.84 | $29.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $138.04 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $56.23 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $218.78 Typical High $218.78 | Professional | 54 · Surgery only | $208.93 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $41.69 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $27.54 | $28.84 | $28.84 |
Where Maine sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$339
AK $977UT $195
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.