How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,549 to $6,761Professionalmedian $708 · 10th to 90th $427 to $933
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $630.96 Median $707.95 Typical High $707.95 | Professional | None | $630.96 | $707.95 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $724.44 Typical High $1,000.00 | Professional | None | $602.56 | $724.44 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $912.01 Median $1,071.52 Typical High $1,479.11 | Professional | 50 · Both sides | $912.01 | $1,071.52 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $446.68 Typical High $630.96 | Professional | 62 · Two surgeons | $380.19 | $446.68 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $158.49 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $100.00 Typical High $138.04 | Professional | AS · PA/NP assist | $85.11 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $6,760.83 | Facility | None | $1,548.82 | $2,137.96 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,148.15 | Professional | None | $676.08 | $741.31 | $1,148.15 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $8,912.51 | Facility | None | $1,513.56 | $2,238.72 | $8,912.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $489.78 Typical High $707.95 | Professional | None | $407.38 | $489.78 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $707.95 Typical High $707.95 | Professional | None | $691.83 | $707.95 | $707.95 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $8,912.51 | Facility | None | $1,513.56 | $2,238.72 | $8,912.51 |
United Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $758.58 | Professional | None | $346.74 | $524.81 | $758.58 |
10 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 $309.03 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $309.03 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $125.89 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $467.74 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $93.33 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $63.10 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $138.04 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $512.86 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $102.33 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $69.18 | $70.79 | $70.79 |
Where Maine sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 23rd of 51
$708
AK $2,455KY $245
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.