How much rates vary
Facilitymedian $2,512 · 10th to 90th $708 to $5,623Professionalmedian $1,380 · 10th to 90th $1,096 to $2,138
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 $1,174.90 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,096.48 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $229.09 Typical High $338.84 | Professional | 80 · Assistant surgeon | $173.78 | $229.09 | $338.84 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $199.53 Typical High $302.00 | Professional | AS · PA/NP assist | $154.88 | $199.53 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,454.71 Typical High $3,890.45 | Facility | None | $707.95 | $2,454.71 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,380.38 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,412.54 | $1,949.84 |
Martin's Point Setting Professional Modifier None Typical Low $1,288.25 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,288.25 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,412.54 Typical High $1,905.46 | Professional | None | $1,071.52 | $1,412.54 | $1,905.46 |
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 $588.84 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $588.84 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $234.42 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $891.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $177.83 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $117.49 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $831.76 | $912.01 | $912.01 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $630.96 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $257.04 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $954.99 Median $977.24 Typical High $977.24 | Professional | 54 · Surgery only | $954.99 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $190.55 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $128.82 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $891.25 | $912.01 | $912.01 |
Where Maine sits
The same service costs 6.2 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· 33rd of 51
$1,380
AK $4,571UT $741
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.