How much rates vary
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 $2,089.30 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,089.30 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,290.87 | $2,951.21 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,445.44 Median $1,862.09 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,445.44 | $1,862.09 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $363.08 Median $478.63 Typical High $724.44 | Professional | 80 · Assistant surgeon | $363.08 | $478.63 | $724.44 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $316.23 Median $416.87 Typical High $630.96 | Professional | AS · PA/NP assist | $316.23 | $416.87 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $13,182.57 Typical High $20,892.96 | Facility | None | $707.95 | $13,182.57 | $20,892.96 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $4,570.88 | Professional | None | $2,454.71 | $3,162.28 | $4,570.88 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,754.23 | $4,365.16 |
Martin's Point Setting Professional Modifier None Typical Low $2,290.87 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,290.87 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,630.27 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,630.27 | $3,630.78 |
4 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 54 · Surgery only Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,698.24 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,995.26 | $1,995.26 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $1,995.26 | $2,137.96 | $2,137.96 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $1,862.09 | $1,995.26 | $1,995.26 |
Where Maine sits
The same service costs 8.1 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· 29th of 51
$2,818
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.