How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,514 to $6,607Professionalmedian $1,585 · 10th to 90th $1,096 to $2,089
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 $1,122.02 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,122.02 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,548.82 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,548.82 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,584.89 Median $2,290.87 Typical High $3,235.94 | Professional | 50 · Both sides | $1,584.89 | $2,290.87 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $977.24 Typical High $1,348.96 | Professional | 62 · Two surgeons | $660.69 | $977.24 | $1,348.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $6,606.93 | Facility | None | $1,513.56 | $2,238.72 | $6,606.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $1,949.84 | Professional | None | $1,148.15 | $1,479.11 | $1,949.84 |
Martin's Point Setting Professional Modifier None Typical Low $1,348.96 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,348.96 | $1,778.28 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $6,606.93 | Facility | None | $1,513.56 | $2,238.72 | $6,606.93 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,096.48 | $1,584.89 | $2,089.30 |
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 $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $891.25 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $354.81 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,318.26 | $1,318.26 | $1,318.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $263.03 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $177.83 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,230.27 | $1,230.27 | $1,230.27 |
Where Maine sits
The same service costs 7.8 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· 24th of 51
$1,622
AK $4,571UT $589
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.