How much rates vary
Facilitymedian $15,488 · 10th to 90th $1,738 to $16,218Professionalmedian $1,096 · 10th to 90th $776 to $1,514
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 $831.76 Median $977.24 Typical High $977.24 | Professional | None | $831.76 | $977.24 | $977.24 |
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 $691.83 Median $1,096.48 Typical High $1,445.44 | Professional | None | $691.83 | $1,096.48 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $436.52 Median $691.83 Typical High $912.01 | Professional | 62 · Two surgeons | $436.52 | $691.83 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $173.78 Typical High $234.42 | Professional | 80 · Assistant surgeon | $109.65 | $173.78 | $234.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $97.72 Median $151.36 Typical High $204.17 | Professional | AS · PA/NP assist | $97.72 | $151.36 | $204.17 |
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 $1,000.00 Median $1,047.13 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,047.13 | $1,698.24 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,513.56 | Professional | None | $851.14 | $1,202.26 | $1,513.56 |
Martin's Point Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $977.24 | Professional | None | $831.76 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,202.26 Typical High $1,513.56 | Professional | None | $851.14 | $1,202.26 | $1,513.56 |
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 $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | 54 · Surgery only | $741.31 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $691.83 | $691.83 | $691.83 |
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· 21st of 51
$1,148
AK $3,090TX $525
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.