How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $257.04 Median $316.23 Typical High $331.13 | Professional | None | $257.04 | $316.23 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $17,782.79 Median $22,908.68 Typical High $23,442.29 | Facility | None | $17,782.79 | $22,908.68 | $23,442.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $537.03 | Professional | None | $245.47 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $58.88 Typical High $85.11 | Professional | 80 · Assistant surgeon | $39.81 | $58.88 | $85.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $51.29 Typical High $74.13 | Professional | AS · PA/NP assist | $34.67 | $51.29 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $2,290.87 | Facility | None | $151.36 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $588.84 | Professional | None | $295.12 | $338.84 | $588.84 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $501.19 | Professional | None | $302.00 | $389.05 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $331.13 | Professional | None | $257.04 | $316.23 | $331.13 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $537.03 | Professional | None | $331.13 | $416.87 | $537.03 |
5 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 $158.49 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $31.62 |
Where Maine sits
The same service costs 3.2 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· 28th of 51
$389
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.