How much rates vary
Facilitymedian $12,303 · 10th to 90th $776 to $12,882Professionalmedian $832 · 10th to 90th $661 to $1,288
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 $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $9,772.37 Median $12,589.25 Typical High $13,182.57 | Facility | None | $9,772.37 | $12,589.25 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,445.44 | Professional | None | $660.69 | $933.25 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $537.03 Typical High $812.83 | Professional | 62 · Two surgeons | $416.87 | $537.03 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $104.71 Median $134.90 Typical High $204.17 | Professional | 80 · Assistant surgeon | $104.71 | $134.90 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $91.20 Median $120.23 Typical High $181.97 | Professional | AS · PA/NP assist | $91.20 | $120.23 | $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 $724.44 Median $977.24 Typical High $1,479.11 | Professional | None | $724.44 | $977.24 | $1,479.11 |
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 $660.69 Median $831.76 Typical High $1,318.26 | Professional | None | $660.69 | $831.76 | $1,318.26 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
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 $630.96 Median $831.76 Typical High $1,318.26 | Professional | None | $630.96 | $831.76 | $1,318.26 |
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 $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $398.11 Typical High $398.11 | Professional | 52 · Reduced service | $338.84 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $138.04 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $588.84 Typical High $588.84 | Professional | 54 · Surgery only | $512.86 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $120.23 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $549.54 Typical High $549.54 | Professional | 78 · Unplanned return to OR | $478.63 | $549.54 | $549.54 |
Where Maine sits
The same service costs 5.4 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· 23rd of 51
$871
AK $2,512TX $468
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.