How much rates vary
Facilitymedian $2,512 · 10th to 90th $813 to $6,761Professionalmedian $1,622 · 10th to 90th $1,288 to $2,512
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 $1,412.54 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,412.54 | $1,548.82 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $2,511.89 | Professional | None | $1,288.25 | $1,698.24 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $812.83 Median $1,071.52 Typical High $1,584.89 | Professional | 62 · Two surgeons | $812.83 | $1,071.52 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $208.93 Median $269.15 Typical High $407.38 | Professional | 80 · Assistant surgeon | $208.93 | $269.15 | $407.38 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $181.97 Median $234.42 Typical High $354.81 | Professional | AS · PA/NP assist | $181.97 | $234.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $4,677.35 Typical High $7,413.10 | Facility | None | $812.83 | $4,677.35 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,621.81 Typical High $2,511.89 | Professional | None | $1,445.44 | $1,621.81 | $2,511.89 |
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 $1,288.25 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,288.25 | $1,659.59 | $2,290.87 |
Martin's Point Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,513.56 | $1,548.82 | $1,548.82 |
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 $1,230.27 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,230.27 | $1,659.59 | $2,238.72 |
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 $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $281.84 | $309.03 | $309.03 |
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 $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $141.25 | $154.88 | $154.88 |
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 $758.58 Median $776.25 Typical High $776.25 | Professional | 52 · Reduced service | $758.58 | $776.25 | $776.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | 53 · Discontinued | $302.00 | $309.03 | $309.03 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,174.90 Typical High $1,174.90 | Professional | 54 · Surgery only | $1,122.02 | $1,174.90 | $1,174.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 55 · Aftercare only | $223.87 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $151.36 Median $154.88 Typical High $154.88 | Professional | 56 · Pre-op care only | $151.36 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,096.48 Typical High $1,096.48 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,096.48 | $1,096.48 |
Where Maine sits
The same service costs 11.0 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
$1,622
AK $5,370TX $490
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.