How much rates vary
Facilitymedian $22,387 · 10th to 90th $2,239 to $22,909Professionalmedian $1,047 · 10th to 90th $776 to $1,585
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 $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $724.44 Median $1,047.13 Typical High $1,584.89 | Professional | None | $724.44 | $1,047.13 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $660.69 Typical High $1,000.00 | Professional | 62 · Two surgeons | $446.68 | $660.69 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $169.82 Typical High $251.19 | Professional | 80 · Assistant surgeon | $114.82 | $169.82 | $251.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $147.91 Typical High $218.78 | Professional | AS · PA/NP assist | $100.00 | $147.91 | $218.78 |
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 $891.25 Median $1,023.29 Typical High $1,778.28 | Professional | None | $891.25 | $1,023.29 | $1,778.28 |
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 $912.01 Median $1,148.15 Typical High $1,513.56 | Professional | None | $912.01 | $1,148.15 | $1,513.56 |
Martin's Point Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $891.25 Median $1,202.26 Typical High $1,584.89 | Professional | None | $891.25 | $1,202.26 | $1,584.89 |
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 $457.09 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $676.08 | Professional | 54 · Surgery only | $676.08 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $630.96 |
Where Maine sits
The same service costs 8.5 times more in Oklahoma 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
$1,175
OK $3,162TX $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.