How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $489.78 Median $812.83 Typical High $812.83 | Professional | None | $489.78 | $812.83 | $812.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $12,589.25 Median $16,218.10 Typical High $16,982.44 | Facility | None | $12,589.25 | $16,218.10 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $602.56 Median $812.83 Typical High $1,000.00 | Professional | None | $602.56 | $812.83 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $512.86 Typical High $630.96 | Professional | 62 · Two surgeons | $380.19 | $512.86 | $630.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $100.00 Median $128.82 Typical High $162.18 | Professional | 80 · Assistant surgeon | $100.00 | $128.82 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $87.10 Median $112.20 Typical High $141.25 | Professional | AS · PA/NP assist | $87.10 | $112.20 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,513.56 | Professional | None | $851.14 | $977.24 | $1,513.56 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,348.96 | Professional | None | $645.65 | $933.25 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $812.83 | Professional | None | $660.69 | $812.83 | $812.83 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $645.65 Median $933.25 Typical High $1,348.96 | Professional | None | $645.65 | $933.25 | $1,348.96 |
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 $371.54 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $371.54 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $346.74 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 54 · Surgery only | $489.78 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $562.34 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $457.09 | $562.34 | $562.34 |
Where Maine sits
The same service costs 8.5 times more in Alaska than in Kentucky. 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· 33rd of 51
$813
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.