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 $114.82 Median $144.54 Typical High $229.09 | Professional | None | $114.82 | $144.54 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $269.15 Typical High $501.19 | Professional | None | $134.90 | $269.15 | $501.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $407.38 Typical High $776.25 | Professional | 50 · Both sides | $199.53 | $407.38 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,187.76 Typical High $2,884.03 | Facility | None | $707.95 | $2,187.76 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $316.23 Typical High $512.86 | Professional | None | $190.55 | $316.23 | $512.86 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $549.54 | Professional | None | $158.49 | $288.40 | $549.54 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $229.09 | Professional | None | $114.82 | $144.54 | $229.09 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $181.97 Median $281.84 Typical High $501.19 | Professional | None | $181.97 | $281.84 | $501.19 |
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 $57.54 Median $72.44 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $72.44 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $28.84 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $109.65 Typical High $173.78 | Professional | 54 · Surgery only | $87.10 | $109.65 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $34.67 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $22.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $72.44 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $72.44 | $114.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $28.84 | $45.71 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $109.65 Typical High $173.78 | Professional | 54 · Surgery only | $87.10 | $109.65 | $173.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $34.67 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $34.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $22.91 |
Where Maine sits
The same service costs 5.8 times more in Alaska than in Hawaii. 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· 35th of 51
$269
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.