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 $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,659.59 Typical High $2,238.72 | Professional | None | $1,023.29 | $1,659.59 | $2,238.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $2,454.71 Typical High $3,311.31 | Professional | 50 · Both sides | $1,513.56 | $2,454.71 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $263.03 Typical High $354.81 | Professional | 80 · Assistant surgeon | $162.18 | $263.03 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $229.09 Typical High $309.03 | Professional | AS · PA/NP assist | $141.25 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $3,388.44 Typical High $5,495.41 | Facility | None | $1,148.15 | $3,388.44 | $5,495.41 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $2,570.40 | Professional | None | $1,445.44 | $1,548.82 | $2,570.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,258.93 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,258.93 | $1,659.59 | $2,137.96 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None | $1,122.02 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $2,511.89 Typical High $5,754.40 | Facility | None | $1,698.24 | $2,511.89 | $5,754.40 |
United Setting Professional Modifier None Typical Low $1,174.90 Median $1,778.28 Typical High $2,344.23 | Professional | None | $1,174.90 | $1,778.28 | $2,344.23 |
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 $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $831.76 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $776.25 | $776.25 | $776.25 |
Where Maine sits
The same service costs 6.8 times more in Alaska than in Texas. 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· 29th of 51
$1,622
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.