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 $537.03 Median $660.69 Typical High $660.69 | Professional | None | $537.03 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $676.08 Typical High $1,023.29 | Professional | None | $524.81 | $676.08 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,023.29 Typical High $1,513.56 | Professional | 50 · Both sides | $776.25 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $426.58 Typical High $645.65 | Professional | 62 · Two surgeons | $331.13 | $426.58 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $109.65 Typical High $162.18 | Professional | 80 · Assistant surgeon | $83.18 | $109.65 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $95.50 Typical High $141.25 | Professional | AS · PA/NP assist | $72.44 | $95.50 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $1,862.09 | Facility | None | $707.95 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $1,071.52 | Professional | None | $575.44 | $741.31 | $1,071.52 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $977.24 | Professional | None | $501.19 | $645.65 | $977.24 |
Martin's Point Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | None | $616.60 | $660.69 | $660.69 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $870.96 | Professional | None | $478.63 | $645.65 | $870.96 |
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 $398.11 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $398.11 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $371.54 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $467.74 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $457.09 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $436.52 | $457.09 | $457.09 |
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
$661
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.