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 $45.71 Median $45.71 Typical High $63.10 | Facility | None | $45.71 | $45.71 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $91.20 | Professional | None | $41.69 | $61.66 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $61.66 Typical High $91.20 | Professional | None | $39.81 | $61.66 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $91.20 Typical High $151.36 | Professional | 50 · Both sides | $60.26 | $91.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $83.18 Typical High $1,412.54 | Facility | None | $37.15 | $83.18 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $67.61 Typical High $87.10 | Professional | None | $48.98 | $67.61 | $87.10 |
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 $38.90 Median $58.88 Typical High $107.15 | Professional | None | $38.90 | $58.88 | $107.15 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $63.10 Typical High $91.20 | Professional | None | $43.65 | $63.10 | $91.20 |
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 $35.48 Median $51.29 Typical High $79.43 | Professional | None | $35.48 | $51.29 | $79.43 |
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 $22.91 Median $22.91 Typical High $31.62 | Professional | 52 · Reduced service | $22.91 | $22.91 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $12.59 | Professional | 53 · Discontinued | $9.12 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 54 · Surgery only | $33.88 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $22.91 Typical High $31.62 | Professional | 52 · Reduced service | $22.91 | $22.91 | $31.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $12.59 | Professional | 53 · Discontinued | $9.12 | $9.12 | $12.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $47.86 | Professional | 54 · Surgery only | $33.88 | $33.88 | $47.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 55 · Aftercare only | $6.92 | $6.92 | $9.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $6.31 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $6.31 |
Where Maine sits
The same service costs 4.1 times more in Alaska than in Florida. 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· 24th of 51
$60.26
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.