How much rates vary
Facilitymedian $26,915 · 10th to 90th $776 to $27,542Professionalmedian $2,630 · 10th to 90th $1,995 to $3,890
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 $2,089.30 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $21,379.62 Median $26,915.35 Typical High $28,183.83 | Facility | None | $21,379.62 | $26,915.35 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,949.84 | $2,951.21 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,951.21 Median $4,365.16 Typical High $5,888.44 | Professional | 50 · Both sides | $2,951.21 | $4,365.16 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,230.27 Median $1,862.09 Typical High $2,454.71 | Professional | 62 · Two surgeons | $1,230.27 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $316.23 Median $467.74 Typical High $630.96 | Professional | 80 · Assistant surgeon | $316.23 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $275.42 Median $407.38 Typical High $549.54 | Professional | AS · PA/NP assist | $275.42 | $407.38 | $549.54 |
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 $2,398.83 Median $2,454.71 Typical High $4,365.16 | Professional | None | $2,398.83 | $2,454.71 | $4,365.16 |
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 $2,137.96 Median $2,884.03 Typical High $3,801.89 | Professional | None | $2,137.96 | $2,884.03 | $3,801.89 |
Martin's Point Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,290.87 | $2,290.87 |
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 $1,995.26 Median $2,884.03 Typical High $3,890.45 | Professional | None | $1,995.26 | $2,884.03 | $3,890.45 |
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 $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,148.15 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $1,737.80 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $1,737.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,621.81 |
Where Maine sits
The same service costs 7.6 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
$2,884
AK $8,318TX $1,096
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.