How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,820 to $4,571Professionalmedian $794 · 10th to 90th $603 to $1,175
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 $602.56 Median $724.44 Typical High $724.44 | Professional | None | $602.56 | $724.44 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,258.93 | Professional | None | $602.56 | $812.83 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,148.15 Typical High $1,737.80 | Professional | 50 · Both sides | $870.96 | $1,148.15 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $371.54 Median $489.78 Typical High $741.31 | Professional | 62 · Two surgeons | $371.54 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $123.03 Typical High $186.21 | Professional | 80 · Assistant surgeon | $93.33 | $123.03 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $107.15 Typical High $162.18 | Professional | AS · PA/NP assist | $81.28 | $107.15 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $1,949.84 Median $2,344.23 Typical High $5,754.40 | Facility | None | $1,949.84 | $2,344.23 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $870.96 Typical High $1,348.96 | Professional | None | $676.08 | $870.96 | $1,348.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,202.26 | Professional | None | $602.56 | $812.83 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | None | $616.60 | $724.44 | $724.44 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,202.26 | Professional | None | $588.84 | $812.83 | $1,202.26 |
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 $309.03 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $309.03 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $436.52 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $338.84 | $363.08 | $363.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $512.86 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $109.65 Typical High $109.65 | Professional | 55 · Aftercare only | $102.33 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $67.61 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $512.86 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $478.63 | $512.86 | $512.86 |
Where Maine sits
The same service costs 5.9 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· 26th of 51
$794
AK $2,455TX $417
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.