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 $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $512.86 | Professional | None | $309.03 | $416.87 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $691.83 Typical High $1,412.54 | Facility | None | $446.68 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $758.58 | Professional | None | $436.52 | $478.63 | $758.58 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $741.31 | Professional | None | $446.68 | $602.56 | $741.31 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $436.52 Median $616.60 Typical High $741.31 | Professional | None | $436.52 | $616.60 | $741.31 |
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 $186.21 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 54 · Surgery only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Where Maine sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 41st of 51
$437
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.