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 $416.87 Median $660.69 Typical High $660.69 | Professional | None | $416.87 | $660.69 | $660.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $794.33 | Professional | None | $512.86 | $630.96 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $398.11 Typical High $501.19 | Professional | 62 · Two surgeons | $323.59 | $398.11 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $100.00 Typical High $125.89 | Professional | 80 · Assistant surgeon | $81.28 | $100.00 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $89.13 Typical High $109.65 | Professional | AS · PA/NP assist | $70.79 | $89.13 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $5,754.40 Typical High $9,120.11 | Facility | None | $2,137.96 | $5,754.40 | $9,120.11 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,230.27 | Professional | None | $724.44 | $851.14 | $1,230.27 |
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 $478.63 Median $691.83 Typical High $1,000.00 | Professional | None | $478.63 | $691.83 | $1,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $537.03 Median $660.69 Typical High $660.69 | Professional | None | $537.03 | $660.69 | $660.69 |
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 $478.63 Median $724.44 Typical High $1,071.52 | Professional | None | $478.63 | $724.44 | $1,071.52 |
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 $309.03 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $309.03 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $288.40 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $501.19 Typical High $501.19 | Professional | 54 · Surgery only | $354.81 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $467.74 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $371.54 | $467.74 | $467.74 |
Where Maine sits
The same service costs 5.9 times more in Alaska than in Hawaii. 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· 30th 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.