How much rates vary
Facilitymedian $22,387 · 10th to 90th $2,239 to $22,909Professionalmedian $759 · 10th to 90th $525 to $1,072
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 $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $17,782.79 Median $22,908.68 Typical High $23,442.29 | Facility | None | $17,782.79 | $22,908.68 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $776.25 Typical High $1,071.52 | Professional | None | $501.19 | $776.25 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $489.78 Typical High $676.08 | Professional | 62 · Two surgeons | $316.23 | $489.78 | $676.08 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $123.03 Typical High $169.82 | Professional | 80 · Assistant surgeon | $81.28 | $123.03 | $169.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $109.65 Typical High $147.91 | Professional | AS · PA/NP assist | $70.79 | $109.65 | $147.91 |
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 $676.08 Median $758.58 Typical High $1,258.93 | Professional | None | $676.08 | $758.58 | $1,258.93 |
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 $630.96 Median $776.25 Typical High $1,023.29 | Professional | None | $630.96 | $776.25 | $1,023.29 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $549.54 Median $812.83 Typical High $1,122.02 | Professional | None | $549.54 | $812.83 | $1,122.02 |
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 $275.42 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $275.42 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 54 · Surgery only | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $389.05 | $389.05 | $389.05 |
Where Maine sits
The same service costs 6.0 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· 28th of 51
$794
AK $2,239UT $372
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.