How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,549 to $5,754Professionalmedian $676 · 10th to 90th $389 to $891
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 $562.34 Median $676.08 Typical High $676.08 | Professional | None | $562.34 | $676.08 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $954.99 | Professional | None | $575.44 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,412.54 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $426.58 Typical High $602.56 | Professional | 62 · Two surgeons | $363.08 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $109.65 Typical High $151.36 | Professional | 80 · Assistant surgeon | $93.33 | $109.65 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $95.50 Typical High $131.83 | Professional | AS · PA/NP assist | $81.28 | $95.50 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $2,137.96 Typical High $5,754.40 | Facility | None | $1,548.82 | $2,137.96 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,096.48 | Professional | None | $645.65 | $707.95 | $1,096.48 |
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 $371.54 Median $446.68 Typical High $645.65 | Professional | None | $371.54 | $446.68 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $676.08 | Professional | None | $562.34 | $676.08 | $676.08 |
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 $316.23 Median $478.63 Typical High $645.65 | Professional | None | $316.23 | $478.63 | $645.65 |
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 $295.12 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $295.12 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $117.49 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $446.68 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $89.13 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $58.88 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $323.59 Median $338.84 Typical High $338.84 | Professional | 52 · Reduced service | $323.59 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $134.90 | Professional | 53 · Discontinued | $128.82 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $489.78 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $100.00 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $67.61 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $67.61 |
Where Maine sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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· 25th of 51
$676
AK $2,344HI $224
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.