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 $1,659.59 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,659.59 | $2,089.30 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $2,137.96 Typical High $3,162.28 | Professional | None | $1,621.81 | $2,137.96 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $3,162.28 Typical High $4,786.30 | Professional | 50 · Both sides | $2,454.71 | $3,162.28 | $4,786.30 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $6,606.93 | Facility | None | $707.95 | $5,011.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,344.23 Typical High $3,388.44 | Professional | None | $1,862.09 | $2,344.23 | $3,388.44 |
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 $1,621.81 Median $1,995.26 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,995.26 | $2,951.21 |
Martin's Point Setting Professional Modifier None Typical Low $1,698.24 Median $2,089.30 Typical High $2,089.30 | Professional | None | $1,698.24 | $2,089.30 | $2,089.30 |
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 $1,548.82 Median $2,041.74 Typical High $2,818.38 | Professional | None | $1,548.82 | $2,041.74 | $2,818.38 |
8 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 $1,258.93 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,258.93 | $1,584.89 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $251.19 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $165.96 | $208.93 | $208.93 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,174.90 | $1,479.11 | $1,479.11 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,584.89 Typical High $1,584.89 | Professional | 54 · Surgery only | $1,479.11 | $1,584.89 | $1,584.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $316.23 Typical High $316.23 | Professional | 55 · Aftercare only | $295.12 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $208.93 Typical High $208.93 | Professional | 56 · Pre-op care only | $194.98 | $208.93 | $208.93 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,479.11 Typical High $1,479.11 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,479.11 | $1,479.11 |
Where Maine sits
The same service costs 7.8 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· 31st of 51
$2,089
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.