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 $1,071.52 Median $1,071.52 Typical High $1,230.27 | Professional | None | $1,071.52 | $1,071.52 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,621.81 Typical High $2,630.27 | Professional | None | $1,122.02 | $1,621.81 | $2,630.27 |
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $1,148.15 Median $1,621.81 Typical High $2,238.72 | Professional | None | $1,148.15 | $1,621.81 | $2,238.72 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,071.52 | $1,071.52 | $1,148.15 |
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 $1,122.02 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,122.02 | $1,621.81 | $2,398.83 |
8 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 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $912.01 | Professional | 54 · Surgery only | $794.33 | $794.33 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $181.97 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $123.03 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $851.14 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | 54 · Surgery only | $794.33 | $794.33 | $851.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $169.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $114.82 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $114.82 |
Martin's Point Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $794.33 |
Where Maine sits
The same service costs 16.2 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· 22nd of 51
$1,318
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.