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 $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $380.19 Median $549.54 Typical High $831.76 | Professional | None | $380.19 | $549.54 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $707.95 Typical High $1,862.09 | Facility | None | $151.36 | $707.95 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $933.25 | Professional | None | $467.74 | $512.86 | $933.25 |
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 $467.74 Median $575.44 Typical High $794.33 | Professional | None | $467.74 | $575.44 | $794.33 |
Martin's Point Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
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 $467.74 Median $588.84 Typical High $851.14 | Professional | None | $467.74 | $588.84 | $851.14 |
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 $234.42 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $234.42 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $93.33 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 54 · Surgery only | $354.81 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $331.13 | $331.13 | $331.13 |
Where Maine sits
The same service costs 6.0 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· 20th of 51
$617
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.