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 $120.23 Median $141.25 Typical High $144.54 | Professional | None | $120.23 | $141.25 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $239.88 | Professional | None | $114.82 | $162.18 | $239.88 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $72.44 Median $93.33 Typical High $141.25 | Professional | 62 · Two surgeons | $72.44 | $93.33 | $141.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $18.20 Median $23.99 Typical High $35.48 | Professional | 80 · Assistant surgeon | $18.20 | $23.99 | $35.48 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $15.85 Median $20.89 Typical High $30.90 | Professional | AS · PA/NP assist | $15.85 | $20.89 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $707.95 Typical High $2,290.87 | Facility | None | $616.60 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $169.82 Typical High $251.19 | Professional | None | $147.91 | $169.82 | $251.19 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $117.49 Median $154.88 Typical High $218.78 | Professional | None | $117.49 | $154.88 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $141.25 | Professional | None | $120.23 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Professional | None | $117.49 | $165.96 | $223.87 |
2 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 $91.20 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $91.20 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $107.15 Typical High $107.15 | Professional | 54 · Surgery only | $102.33 | $107.15 | $107.15 |
Where Maine sits
The same service costs 4.9 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· 23rd of 51
$155
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.