How much rates vary
Facilitymedian $32,359 · 10th to 90th $776 to $33,113Professionalmedian $4,365 · 10th to 90th $3,162 to $6,166
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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $3,090.30 Median $4,570.88 Typical High $6,165.95 | Professional | None | $3,090.30 | $4,570.88 | $6,165.95 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,949.84 Median $2,884.03 Typical High $3,890.45 | Professional | 62 · Two surgeons | $1,949.84 | $2,884.03 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $489.78 Median $741.31 Typical High $977.24 | Professional | 80 · Assistant surgeon | $489.78 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $426.58 Median $645.65 Typical High $870.96 | Professional | AS · PA/NP assist | $426.58 | $645.65 | $870.96 |
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 $3,801.89 Median $3,981.07 Typical High $6,918.31 | Professional | None | $3,801.89 | $3,981.07 | $6,918.31 |
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 $3,548.13 Median $4,570.88 Typical High $6,025.60 | Professional | None | $3,548.13 | $4,570.88 | $6,025.60 |
Martin's Point Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $3,467.37 Median $4,786.30 Typical High $6,165.95 | Professional | None | $3,467.37 | $4,786.30 | $6,165.95 |
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 $1,819.70 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $1,819.70 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $724.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | 54 · Surgery only | $2,691.53 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,511.89 | $2,511.89 |
Where Maine sits
The same service costs 18.2 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· 18th of 51
$4,571
AK $13,183TX $724
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.