How much rates vary
Facilitymedian $15,849 · 10th to 90th $776 to $16,596Professionalmedian $1,148 · 10th to 90th $977 to $1,660
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $933.25 Median $1,148.15 Typical High $1,380.38 | Professional | None | $933.25 | $1,148.15 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $181.97 Typical High $223.87 | Professional | 80 · Assistant surgeon | $154.88 | $181.97 | $223.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $162.18 Typical High $194.98 | Professional | AS · PA/NP assist | $131.83 | $162.18 | $194.98 |
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 $331.13 Median $562.34 Typical High $1,047.13 | Professional | None | $331.13 | $562.34 | $1,047.13 |
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 |
Martin's Point Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 |
10 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 $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $831.76 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $331.13 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,230.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $165.96 |
Where Maine sits
The same service costs 204.2 times more in Wisconsin 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· 38th of 51
$1,230
WI $6,026HI $29.51
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.