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 $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $851.14 | Professional | None | $389.05 | $602.56 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $371.54 Typical High $524.81 | Professional | 62 · Two surgeons | $245.47 | $371.54 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $95.50 Typical High $134.90 | Professional | 80 · Assistant surgeon | $61.66 | $95.50 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $83.18 Typical High $117.49 | Professional | AS · PA/NP assist | $54.95 | $83.18 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,995.26 Typical High $3,090.30 | Facility | None | $812.83 | $1,995.26 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $602.56 Typical High $977.24 | Professional | None | $537.03 | $602.56 | $977.24 |
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 $467.74 Median $630.96 Typical High $812.83 | Professional | None | $467.74 | $630.96 | $812.83 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
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 $446.68 Median $676.08 Typical High $870.96 | Professional | None | $446.68 | $676.08 | $870.96 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $323.59 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $302.00 | $302.00 | $302.00 |
Where Maine sits
The same service costs 7.1 times more in Alaska 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· 32nd of 51
$603
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.