How much rates vary
Facilitymedian $22,909 · 10th to 90th $776 to $23,442Professionalmedian $2,692 · 10th to 90th $1,905 to $3,631
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 $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,698.24 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,698.24 | $2,691.53 | $3,548.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,071.52 Median $1,698.24 Typical High $2,238.72 | Professional | 62 · Two surgeons | $1,071.52 | $1,698.24 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $426.58 Typical High $575.44 | Professional | 80 · Assistant surgeon | $269.15 | $426.58 | $575.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $371.54 Typical High $501.19 | Professional | AS · PA/NP assist | $234.42 | $371.54 | $501.19 |
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 $2,454.71 Median $2,570.40 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,570.40 | $4,168.69 |
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 $2,089.30 Median $2,691.53 Typical High $3,467.37 | Professional | None | $2,089.30 | $2,691.53 | $3,467.37 |
Martin's Point Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
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 $1,949.84 Median $2,951.21 Typical High $3,715.35 | Professional | None | $1,949.84 | $2,951.21 | $3,715.35 |
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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 53 · Discontinued | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 56 · Pre-op care only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,698.24 | $1,698.24 | $1,698.24 |
Where Maine sits
The same service costs 6.0 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· 17th of 51
$2,692
AK $7,586TX $1,259
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.