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 $40.74 Median $100.00 Typical High $5,754.40 | Facility | None | $40.74 | $100.00 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $81.28 Typical High $194.98 | Professional | None | $40.74 | $81.28 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $91.20 Typical High $204.17 | Professional | None | $48.98 | $91.20 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $234.42 | Professional | None | $54.95 | $114.82 | $234.42 |
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 $58.88 Median $109.65 Typical High $213.80 | Professional | None | $58.88 | $109.65 | $213.80 |
Martin's Point Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $16,595.87 | Facility | None | $5,754.40 | $5,754.40 | $16,595.87 |
Martin's Point Setting Professional Modifier None Typical Low $40.74 Median $81.28 Typical High $194.98 | Professional | None | $40.74 | $81.28 | $194.98 |
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 $67.61 Median $104.71 Typical High $199.53 | Professional | None | $67.61 | $104.71 | $199.53 |
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 $20.42 Median $24.55 Typical High $48.98 | Professional | 52 · Reduced service | $20.42 | $24.55 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.77 Typical High $19.95 | Professional | 53 · Discontinued | $8.13 | $9.77 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $36.31 Typical High $74.13 | Professional | 54 · Surgery only | $30.20 | $36.31 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $14.79 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.90 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.07 | $4.90 | $10.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.42 Median $24.55 Typical High $48.98 | Professional | 52 · Reduced service | $20.42 | $24.55 | $48.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $9.77 Typical High $19.95 | Professional | 53 · Discontinued | $8.13 | $9.77 | $19.95 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $36.31 Typical High $74.13 | Professional | 54 · Surgery only | $30.20 | $36.31 | $74.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.24 Typical High $14.79 | Professional | 55 · Aftercare only | $6.03 | $7.24 | $14.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.90 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.07 | $4.90 | $10.00 |
Where Maine sits
The same service costs 3.4 times more in Alaska than in New Jersey. 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· 39th of 51
$97.72
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.