How much rates vary
Facilitymedian $22,909 · 10th to 90th $2,239 to $23,442Professionalmedian $1,950 · 10th to 90th $1,413 to $2,692
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 $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $18,197.01 Median $23,442.29 Typical High $23,988.33 | Facility | None | $18,197.01 | $23,442.29 | $23,988.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,630.27 | Professional | None | $1,230.27 | $1,995.26 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,951.21 Typical High $3,981.07 | Professional | 50 · Both sides | $1,862.09 | $2,951.21 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,258.93 Typical High $1,659.59 | Professional | 62 · Two surgeons | $776.25 | $1,258.93 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $316.23 Typical High $416.87 | Professional | 80 · Assistant surgeon | $199.53 | $316.23 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $275.42 Typical High $371.54 | Professional | AS · PA/NP assist | $173.78 | $275.42 | $371.54 |
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 $1,819.70 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,819.70 | $1,905.46 | $3,090.30 |
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 $1,548.82 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,548.82 | $1,995.26 | $2,570.40 |
Martin's Point Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,778.28 | $1,778.28 | $1,778.28 |
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 $1,513.56 Median $2,187.76 Typical High $2,754.23 | Professional | None | $1,513.56 | $2,187.76 | $2,754.23 |
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 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 54 · Surgery only | $1,348.96 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 55 · Aftercare only | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,258.93 | $1,258.93 |
Where Maine sits
The same service costs 5.8 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· 22nd of 51
$2,042
AK $5,623UT $977
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.