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 $239.88 Median $239.88 Typical High $537.03 | Professional | None | $239.88 | $239.88 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $275.42 | Professional | None | $165.96 | $218.78 | $275.42 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $104.71 Median $138.04 Typical High $173.78 | Professional | 62 · Two surgeons | $104.71 | $138.04 | $173.78 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $26.30 Median $35.48 Typical High $43.65 | Professional | 80 · Assistant surgeon | $26.30 | $35.48 | $43.65 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $22.91 Median $30.90 Typical High $38.90 | Professional | AS · PA/NP assist | $22.91 | $30.90 | $38.90 |
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 $269.15 Median $269.15 Typical High $436.52 | Professional | None | $269.15 | $269.15 | $436.52 |
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 $199.53 Median $275.42 Typical High $389.05 | Professional | None | $199.53 | $275.42 | $389.05 |
Martin's Point Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $537.03 | Professional | None | $239.88 | $239.88 | $537.03 |
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 $194.98 Median $302.00 Typical High $407.38 | Professional | None | $194.98 | $302.00 | $407.38 |
3 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 $181.97 Median $181.97 Typical High $181.97 | Professional | 54 · Surgery only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $23.99 | $23.99 | $23.99 |
Where Maine sits
The same service costs 10.5 times more in North Dakota 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· 42nd of 51
$240
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.