How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $708Professionalmedian $708 · 10th to 90th $575 to $1,122
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 $575.44 Median $691.83 Typical High $691.83 | Professional | None | $575.44 | $691.83 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,122.02 | Professional | None | $575.44 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $363.08 Median $467.74 Typical High $707.95 | Professional | 62 · Two surgeons | $363.08 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $91.20 Median $120.23 Typical High $177.83 | Professional | 80 · Assistant surgeon | $91.20 | $120.23 | $177.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $104.71 Typical High $154.88 | Professional | AS · PA/NP assist | $79.43 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $707.95 Typical High $2,290.87 | Facility | None | $616.60 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $1,202.26 | Professional | None | $676.08 | $724.44 | $1,202.26 |
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 $588.84 Median $707.95 Typical High $977.24 | Professional | None | $588.84 | $707.95 | $977.24 |
Martin's Point Setting Professional Modifier None Typical Low $575.44 Median $691.83 Typical High $691.83 | Professional | None | $575.44 | $691.83 | $691.83 |
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 $549.54 Median $724.44 Typical High $977.24 | Professional | None | $549.54 | $724.44 | $977.24 |
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 $309.03 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $309.03 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $123.03 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $467.74 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $93.33 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $61.66 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $338.84 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $134.90 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $501.19 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $100.00 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $67.61 | $69.18 | $69.18 |
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
$708
AK $2,399UT $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.