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 $398.11 Median $467.74 Typical High $707.95 | Professional | None | $398.11 | $467.74 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $794.33 | Professional | None | $380.19 | $489.78 | $794.33 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $234.42 Median $288.40 Typical High $467.74 | Professional | 62 · Two surgeons | $234.42 | $288.40 | $467.74 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $60.26 Median $74.13 Typical High $117.49 | Professional | 80 · Assistant surgeon | $60.26 | $74.13 | $117.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $52.48 Median $64.57 Typical High $104.71 | Professional | AS · PA/NP assist | $52.48 | $64.57 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $851.14 | Professional | None | $446.68 | $562.34 | $851.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $758.58 | Professional | None | $389.05 | $524.81 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $707.95 | Professional | None | $398.11 | $467.74 | $707.95 |
United Setting Professional Modifier None Typical Low $380.19 Median $549.54 Typical High $758.58 | Professional | None | $380.19 | $549.54 | $758.58 |
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 $331.13 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $331.13 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $309.03 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 54 · Surgery only | $338.84 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $316.23 | $323.59 | $323.59 |
Where Maine sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 24th of 51
$501
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.