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 $2,238.72 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,238.72 | $2,754.23 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $4,365.16 | Professional | None | $2,187.76 | $2,884.03 | $4,365.16 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,348.96 Median $1,819.70 Typical High $2,754.23 | Professional | 62 · Two surgeons | $1,348.96 | $1,819.70 | $2,754.23 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $457.09 Typical High $707.95 | Professional | 80 · Assistant surgeon | $346.74 | $457.09 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $302.00 Median $407.38 Typical High $616.60 | Professional | AS · PA/NP assist | $302.00 | $407.38 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,168.69 Typical High $6,606.93 | Facility | None | $707.95 | $4,168.69 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,090.30 Typical High $4,466.84 | Professional | None | $2,290.87 | $3,090.30 | $4,466.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $4,265.80 | Professional | None | $2,137.96 | $2,754.23 | $4,265.80 |
Martin's Point Setting Professional Modifier None Typical Low $2,630.27 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,630.27 | $2,754.23 | $2,754.23 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,630.27 | $3,467.37 |
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 $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,659.59 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,548.82 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,548.82 | $1,949.84 | $1,949.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $2,089.30 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,949.84 | $2,089.30 | $2,089.30 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $1,949.84 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,819.70 | $1,949.84 | $1,949.84 |
Where Maine sits
The same service costs 9.1 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· 27th of 51
$2,754
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.