How much rates vary
Facilitymedian $32,359 · 10th to 90th $776 to $33,113Professionalmedian $2,239 · 10th to 90th $1,660 to $3,311
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 $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,659.59 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,659.59 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,047.13 Median $1,548.82 Typical High $2,041.74 | Professional | 62 · Two surgeons | $1,047.13 | $1,548.82 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $269.15 Median $389.05 Typical High $524.81 | Professional | 80 · Assistant surgeon | $269.15 | $389.05 | $524.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $234.42 Median $346.74 Typical High $457.09 | Professional | AS · PA/NP assist | $234.42 | $346.74 | $457.09 |
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 $2,041.74 Median $2,137.96 Typical High $3,715.35 | Professional | None | $2,041.74 | $2,137.96 | $3,715.35 |
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 $1,905.46 Median $2,454.71 Typical High $3,235.94 | Professional | None | $1,905.46 | $2,454.71 | $3,235.94 |
Martin's Point Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,905.46 | $1,905.46 | $1,905.46 |
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 $1,819.70 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,819.70 | $2,454.71 | $3,311.31 |
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 $954.99 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $954.99 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 53 · Discontinued | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | 56 · Pre-op care only | $190.55 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,348.96 | $1,348.96 | $1,348.96 |
Where Maine sits
The same service costs 5.9 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· 17th of 51
$2,455
AK $6,918TX $1,175
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.