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 $446.68 Median $537.03 Typical High $794.33 | Professional | None | $446.68 | $537.03 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $11,481.54 Median $14,454.40 Typical High $15,135.61 | Facility | None | $11,481.54 | $14,454.40 | $15,135.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $912.01 | Professional | None | $426.58 | $645.65 | $912.01 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $269.15 Median $398.11 Typical High $575.44 | Professional | 62 · Two surgeons | $269.15 | $398.11 | $575.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $102.33 Typical High $147.91 | Professional | 80 · Assistant surgeon | $67.61 | $102.33 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $60.26 Median $89.13 Typical High $128.82 | Professional | AS · PA/NP assist | $60.26 | $89.13 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $1,023.29 | Professional | None | $512.86 | $588.84 | $1,023.29 |
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 $524.81 Median $691.83 Typical High $870.96 | Professional | None | $524.81 | $691.83 | $870.96 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | None | $446.68 | $537.03 | $794.33 |
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 $575.44 Median $741.31 Typical High $912.01 | Professional | None | $575.44 | $741.31 | $912.01 |
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 $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 $53.70 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Where Maine sits
The same service costs 3.4 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· 18th of 51
$676
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.