How much rates vary
Facilitymedian $32,359 · 10th to 90th $2,884 to $33,113Professionalmedian $1,660 · 10th to 90th $1,349 to $2,692
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 $1,412.54 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,412.54 | $1,584.89 | $1,584.89 |
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 $1,380.38 Median $1,862.09 Typical High $2,691.53 | Professional | None | $1,380.38 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,041.74 Median $2,818.38 Typical High $4,073.80 | Professional | 50 · Both sides | $2,041.74 | $2,818.38 | $4,073.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,174.90 Typical High $1,698.24 | Professional | 62 · Two surgeons | $870.96 | $1,174.90 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $218.78 Median $302.00 Typical High $426.58 | Professional | 80 · Assistant surgeon | $218.78 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $190.55 Median $263.03 Typical High $380.19 | Professional | AS · PA/NP assist | $190.55 | $263.03 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $5,754.40 | Facility | None | $151.36 | $707.95 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $2,570.40 | Professional | None | $1,479.11 | $1,659.59 | $2,570.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $2,691.53 | Professional | None | $1,318.26 | $1,698.24 | $2,691.53 |
Martin's Point Setting Professional Modifier None Typical Low $1,548.82 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,548.82 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,290.87 | Professional | None | $1,202.26 | $1,698.24 | $2,290.87 |
12 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 $707.95 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $707.95 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $281.84 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,047.13 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $208.93 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $141.25 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $977.24 | $1,096.48 | $1,096.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $776.25 | $776.25 | $776.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $309.03 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,174.90 | $1,174.90 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $234.42 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $154.88 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,096.48 | $1,096.48 |
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· 32nd of 51
$1,698
AK $5,754TX $977
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.