How much rates vary
Facilitymedian $15,849 · 10th to 90th $776 to $16,596Professionalmedian $1,349 · 10th to 90th $1,000 to $1,995
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 $851.14 Median $1,348.96 Typical High $1,348.96 | Professional | None | $851.14 | $1,348.96 | $1,348.96 |
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 $933.25 Median $1,174.90 Typical High $1,318.26 | Professional | None | $933.25 | $1,174.90 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $741.31 Typical High $812.83 | Professional | 62 · Two surgeons | $588.84 | $741.31 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $190.55 Typical High $208.93 | Professional | 80 · Assistant surgeon | $151.36 | $190.55 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $165.96 Typical High $181.97 | Professional | AS · PA/NP assist | $131.83 | $165.96 | $181.97 |
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 $1,318.26 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,318.26 | $1,621.81 | $2,511.89 |
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 $1,023.29 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,023.29 | $1,445.44 | $2,041.74 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,348.96 | $1,348.96 |
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 $1,000.00 Median $1,380.38 Typical High $2,187.76 | Professional | None | $1,000.00 | $1,380.38 | $2,187.76 |
6 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 54 · Surgery only Typical Low $645.65 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $645.65 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $128.82 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $85.11 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $134.90 |
Where Maine sits
The same service costs 5.6 times more in Alaska than in New York. 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· 30th of 51
$1,349
AK $4,786NY $851
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.