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 Facility Modifier None Typical Low $23.99 Median $31.62 Typical High $66.07 | Facility | None | $23.99 | $31.62 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $58.88 Typical High $144.54 | Professional | None | $23.99 | $58.88 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $77.62 Typical High $147.91 | Professional | None | $28.18 | $77.62 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $707.95 | Facility | None | $56.23 | $107.15 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $72.44 Typical High $173.78 | Professional | None | $31.62 | $72.44 | $173.78 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $66.07 Typical High $144.54 | Professional | None | $36.31 | $66.07 | $144.54 |
Martin's Point Setting Facility Modifier None Typical Low $23.99 Median $31.62 Typical High $107.15 | Facility | None | $23.99 | $31.62 | $107.15 |
Martin's Point Setting Professional Modifier None Typical Low $23.99 Median $64.57 Typical High $144.54 | Professional | None | $23.99 | $64.57 | $144.54 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $123.03 | Professional | None | $39.81 | $66.07 | $123.03 |
10 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 $11.75 Median $16.60 Typical High $33.11 | Professional | 52 · Reduced service | $11.75 | $16.60 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $6.61 Typical High $13.18 | Professional | 53 · Discontinued | $4.79 | $6.61 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $25.12 Typical High $48.98 | Professional | 54 · Surgery only | $17.78 | $25.12 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.01 Typical High $9.77 | Professional | 55 · Aftercare only | $3.55 | $5.01 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $3.31 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.40 | $3.31 | $6.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $14.13 Typical High $33.11 | Professional | 52 · Reduced service | $11.75 | $14.13 | $33.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.62 Typical High $13.18 | Professional | 53 · Discontinued | $4.79 | $5.62 | $13.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $21.38 Typical High $48.98 | Professional | 54 · Surgery only | $17.78 | $21.38 | $48.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $4.27 Typical High $9.77 | Professional | 55 · Aftercare only | $3.55 | $4.27 | $9.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.82 Typical High $6.61 | Professional | 56 · Pre-op care only | $2.40 | $2.82 | $6.61 |
Where Maine sits
The same service costs 3.5 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· 42nd of 51
$66.07
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.