How much rates vary
Facilitymedian $2,344 · 10th to 90th $1,202 to $5,754Professionalmedian $1,259 · 10th to 90th $1,000 to $1,862
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 Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,023.29 | $1,202.26 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,905.46 | Professional | None | $977.24 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $794.33 Typical High $1,202.26 | Professional | 62 · Two surgeons | $616.60 | $794.33 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $204.17 Typical High $309.03 | Professional | 80 · Assistant surgeon | $154.88 | $204.17 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $177.83 Typical High $269.15 | Professional | AS · PA/NP assist | $134.90 | $177.83 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,677.35 Typical High $7,413.10 | Facility | None | $707.95 | $4,677.35 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,258.93 | $1,905.46 |
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 $1,000.00 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,288.25 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,202.26 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,202.26 | $1,737.80 |
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 $912.01 Median $1,288.25 Typical High $1,737.80 | Professional | None | $912.01 | $1,288.25 | $1,737.80 |
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 $537.03 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $537.03 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $213.80 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $794.33 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $158.49 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $107.15 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $741.31 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $575.44 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $575.44 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $229.09 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $851.14 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $173.78 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $831.76 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $794.33 | $831.76 | $831.76 |
Where Maine sits
The same service costs 4.4 times more in Alaska than in Hawaii. 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.
Physician feeFacility fee
AK $10,992HI $2,489
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.