How much rates vary
Facilitymedian $32,359 · 10th to 90th $776 to $33,113Professionalmedian $1,995 · 10th to 90th $1,413 to $2,818
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 $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $25,703.96 Median $33,113.11 Typical High $33,884.42 | Facility | None | $25,703.96 | $33,113.11 | $33,884.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,412.54 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,137.96 Median $3,162.28 Typical High $4,168.69 | Professional | 50 · Both sides | $2,137.96 | $3,162.28 | $4,168.69 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,318.26 Typical High $1,778.28 | Professional | 62 · Two surgeons | $891.25 | $1,318.26 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $229.09 Median $338.84 Typical High $446.68 | Professional | 80 · Assistant surgeon | $229.09 | $338.84 | $446.68 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $295.12 Typical High $389.05 | Professional | AS · PA/NP assist | $199.53 | $295.12 | $389.05 |
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 $1,737.80 Median $1,819.70 Typical High $3,162.28 | Professional | None | $1,737.80 | $1,819.70 | $3,162.28 |
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 $1,621.81 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,621.81 | $2,137.96 | $2,754.23 |
Martin's Point Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $1,621.81 | $1,621.81 | $1,621.81 |
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 $1,479.11 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,479.11 | $2,187.76 | $2,818.38 |
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 $812.83 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $812.83 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $162.18 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,148.15 | $1,148.15 |
Where Maine sits
The same service costs 7.8 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· 16th of 51
$2,089
AK $5,888TX $759
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.