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 $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | None | $316.23 | $478.63 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,949.84 Typical High $3,090.30 | Facility | None | $537.03 | $1,949.84 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $794.33 | Professional | None | $416.87 | $501.19 | $794.33 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $645.65 | Professional | None | $346.74 | $489.78 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $724.44 | Professional | None | $338.84 | $489.78 | $724.44 |
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 $169.82 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | 54 · Surgery only | $257.04 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $239.88 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $239.88 | $239.88 | $239.88 |
Where Maine sits
The same service costs 8.5 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· 30th of 51
$479
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.