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 $288.40 Median $323.59 Typical High $2,691.53 | Professional | None | $288.40 | $323.59 | $2,691.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $218.78 Median $891.25 Typical High $4,265.80 | Professional | None | $218.78 | $891.25 | $4,265.80 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,348.96 Typical High $4,466.84 | Facility | None | $707.95 | $1,348.96 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $1,737.80 Typical High $4,466.84 | Professional | None | $302.00 | $1,737.80 | $4,466.84 |
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 $251.19 Median $1,548.82 Typical High $4,570.88 | Professional | None | $251.19 | $1,548.82 | $4,570.88 |
Martin's Point Setting Professional Modifier None Typical Low $288.40 Median $323.59 Typical High $2,691.53 | Professional | None | $288.40 | $323.59 | $2,691.53 |
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 $302.00 Median $588.84 Typical High $3,548.13 | Professional | None | $302.00 | $588.84 | $3,548.13 |
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 $213.80 Median $239.88 Typical High $2,041.74 | Professional | 54 · Surgery only | $213.80 | $239.88 | $2,041.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $1,905.46 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $239.88 Typical High $2,041.74 | Professional | 54 · Surgery only | $213.80 | $239.88 | $2,041.74 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $223.87 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $199.53 | $223.87 | $1,905.46 |
Where Maine sits
The same service costs 7.1 times more in Oregon than in Texas. 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· 40th of 51
$1,259
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.