How much rates vary
Facilitymedian $525 · 10th to 90th $457 to $708Professionalmedian $447 · 10th to 90th $355 to $676
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 $389.05 Median $426.58 Typical High $426.58 | Professional | None | $389.05 | $426.58 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $457.09 Typical High $691.83 | Professional | None | $346.74 | $457.09 | $691.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $72.44 Typical High $109.65 | Professional | 80 · Assistant surgeon | $56.23 | $72.44 | $109.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $63.10 Typical High $95.50 | Professional | AS · PA/NP assist | $48.98 | $63.10 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $537.03 Typical High $2,290.87 | Facility | None | $457.09 | $537.03 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $758.58 | Professional | None | $416.87 | $446.68 | $758.58 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $630.96 | Professional | None | $363.08 | $446.68 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $426.58 | Professional | None | $407.38 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $630.96 | Professional | None | $346.74 | $467.74 | $630.96 |
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 $194.98 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $194.98 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $77.62 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $295.12 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $58.88 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $204.17 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $83.18 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $61.66 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $42.66 |
Where Maine sits
The same service costs 4.9 times more in Alaska than in Utah. 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· 36th of 51
$447
AK $1,445UT $295
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.