How much rates vary
Facilitymedian $1,778 · 10th to 90th $1,072 to $3,236Professionalmedian $447 · 10th to 90th $324 to $724
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 $446.68 Median $446.68 Typical High $707.95 | Professional | None | $446.68 | $446.68 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $562.34 | Professional | None | $263.03 | $407.38 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $616.60 Typical High $831.76 | Professional | 50 · Both sides | $407.38 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $257.04 Typical High $354.81 | Professional | 62 · Two surgeons | $173.78 | $257.04 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $3,235.94 | Facility | None | $1,148.15 | $1,479.11 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $575.44 Typical High $870.96 | Professional | None | $446.68 | $575.44 | $870.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $501.19 Typical High $758.58 | Professional | None | $323.59 | $501.19 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $707.95 | Professional | None | $446.68 | $446.68 | $707.95 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $758.58 | Professional | None | $302.00 | $489.78 | $758.58 |
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 $223.87 Median $223.87 Typical High $354.81 | Professional | 52 · Reduced service | $223.87 | $223.87 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $141.25 | Professional | 53 · Discontinued | $89.13 | $89.13 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $489.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $354.81 | Professional | 52 · Reduced service | $223.87 | $223.87 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $141.25 | Professional | 53 · Discontinued | $89.13 | $89.13 | $141.25 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $524.81 | Professional | 54 · Surgery only | $338.84 | $338.84 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $107.15 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $70.79 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $70.79 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $489.78 |
Where Maine sits
The same service costs 5.5 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· 28th of 51
$468
AK $1,585UT $288
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.