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 $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $794.33 Typical High $1,071.52 | Professional | None | $537.03 | $794.33 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $812.83 Median $1,202.26 Typical High $1,584.89 | Professional | 50 · Both sides | $812.83 | $1,202.26 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $501.19 Typical High $676.08 | Professional | 62 · Two surgeons | $338.84 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $3,235.94 | Facility | None | $1,148.15 | $2,344.23 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,230.27 | Professional | None | $691.83 | $758.58 | $1,230.27 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $812.83 Typical High $1,071.52 | Professional | None | $588.84 | $812.83 | $1,071.52 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $549.54 Median $831.76 Typical High $1,096.48 | Professional | None | $549.54 | $831.76 | $1,096.48 |
6 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 52 · Reduced service Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $380.19 | $380.19 | $380.19 |
Where Maine sits
The same service costs 8.7 times more in Oklahoma 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· 31st of 51
$776
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.