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 $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $676.08 Typical High $891.25 | Professional | None | $446.68 | $676.08 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $70.79 Median $107.15 Typical High $144.54 | Professional | 80 · Assistant surgeon | $70.79 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $63.10 Median $93.33 Typical High $125.89 | Professional | AS · PA/NP assist | $63.10 | $93.33 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,754.40 Typical High $9,120.11 | Facility | None | $707.95 | $5,754.40 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $1,023.29 | Professional | None | $602.56 | $630.96 | $1,023.29 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $912.01 | Professional | None | $549.54 | $691.83 | $912.01 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $912.01 | Professional | None | $575.44 | $741.31 | $912.01 |
5 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 $288.40 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Where Maine sits
The same service costs 3.9 times more in Alaska than in New York. 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· 36th of 51
$676
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.