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 $316.23 Median $331.13 Typical High $331.13 | Professional | None | $316.23 | $331.13 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $645.65 | Professional | None | $302.00 | $446.68 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $47.86 Median $72.44 Typical High $102.33 | Professional | 80 · Assistant surgeon | $47.86 | $72.44 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $41.69 Median $63.10 Typical High $91.20 | Professional | AS · PA/NP assist | $41.69 | $63.10 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $812.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $741.31 | Professional | None | $398.11 | $467.74 | $741.31 |
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 $354.81 Median $457.09 Typical High $616.60 | Professional | None | $354.81 | $457.09 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $331.13 | Professional | None | $316.23 | $331.13 | $331.13 |
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 $331.13 Median $467.74 Typical High $676.08 | Professional | None | $331.13 | $467.74 | $676.08 |
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 $165.96 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $229.09 | $229.09 | $229.09 |
Where Maine sits
The same service costs 11.2 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
$447
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.