How much rates vary
Facilitymedian $15,488 · 10th to 90th $776 to $16,218Professionalmedian $1,905 · 10th to 90th $1,380 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 $12,302.69 Median $15,848.93 Typical High $16,595.87 | Facility | None | $12,302.69 | $15,848.93 | $16,595.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,995.26 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $831.76 Median $1,258.93 Typical High $1,698.24 | Professional | 62 · Two surgeons | $831.76 | $1,258.93 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $323.59 Typical High $426.58 | Professional | 80 · Assistant surgeon | $213.80 | $323.59 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $281.84 Typical High $380.19 | Professional | AS · PA/NP assist | $186.21 | $281.84 | $380.19 |
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 $1,778.28 Median $1,905.46 Typical High $3,090.30 | Professional | None | $1,778.28 | $1,905.46 | $3,090.30 |
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 $1,513.56 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,513.56 | $1,949.84 | $2,691.53 |
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 $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 $1,412.54 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,412.54 | $1,995.26 | $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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
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 $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Maine sits
The same service costs 21.4 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· 15th of 51
$1,995
AK $5,754TX $269
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.