How much rates vary
Facilitymedian $22,387 · 10th to 90th $2,239 to $22,909Professionalmedian $977 · 10th to 90th $692 to $1,380
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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $630.96 Median $1,000.00 Typical High $1,380.38 | Professional | None | $630.96 | $1,000.00 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $954.99 Median $1,513.56 Typical High $2,041.74 | Professional | 50 · Both sides | $954.99 | $1,513.56 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $398.11 Median $630.96 Typical High $870.96 | Professional | 62 · Two surgeons | $398.11 | $630.96 | $870.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $102.33 Median $158.49 Typical High $218.78 | Professional | 80 · Assistant surgeon | $102.33 | $158.49 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $89.13 Median $141.25 Typical High $190.55 | Professional | AS · PA/NP assist | $89.13 | $141.25 | $190.55 |
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 $870.96 Median $977.24 Typical High $1,584.89 | Professional | None | $870.96 | $977.24 | $1,584.89 |
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 $776.25 Median $1,023.29 Typical High $1,348.96 | Professional | None | $776.25 | $1,023.29 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $741.31 Median $1,122.02 Typical High $1,412.54 | Professional | None | $741.31 | $1,122.02 | $1,412.54 |
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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $501.19 | $501.19 | $501.19 |
Where Maine sits
The same service costs 6.9 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· 25th of 51
$1,023
AK $2,884TX $417
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.