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 $426.58 Median $501.19 Typical High $524.81 | Professional | None | $426.58 | $501.19 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $851.14 | Professional | None | $398.11 | $524.81 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $251.19 Median $309.03 Typical High $501.19 | Professional | 62 · Two surgeons | $251.19 | $309.03 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $64.57 Median $79.43 Typical High $125.89 | Professional | 80 · Assistant surgeon | $64.57 | $79.43 | $125.89 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $56.23 Median $69.18 Typical High $109.65 | Professional | AS · PA/NP assist | $56.23 | $69.18 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $891.25 | Professional | None | $478.63 | $602.56 | $891.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $794.33 | Professional | None | $416.87 | $562.34 | $794.33 |
Martin's Point Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $512.86 | Professional | None | $426.58 | $501.19 | $512.86 |
United Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $812.83 | Professional | None | $407.38 | $575.44 | $812.83 |
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 $346.74 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $346.74 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $323.59 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $363.08 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $346.74 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $338.84 | $346.74 | $346.74 |
Where Maine sits
The same service costs 4.4 times more in Alaska 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· 25th of 51
$537
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.