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 $5,128.61 Median $5,128.61 Typical High $9,549.93 | Facility | None | $5,128.61 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $109.65 | Professional | None | $51.29 | $72.44 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $114.82 | Professional | None | $46.77 | $74.13 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $109.65 Typical High $1,412.54 | Facility | None | $48.98 | $109.65 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $100.00 | Professional | None | $56.23 | $77.62 | $100.00 |
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 $45.71 Median $69.18 Typical High $128.82 | Professional | None | $45.71 | $69.18 | $128.82 |
Martin's Point Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $9,549.93 | Facility | None | $5,128.61 | $5,128.61 | $9,549.93 |
Martin's Point Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $109.65 | Professional | None | $51.29 | $72.44 | $109.65 |
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 $41.69 Median $63.10 Typical High $100.00 | Professional | None | $41.69 | $63.10 | $100.00 |
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 $26.30 Median $26.30 Typical High $38.90 | Professional | 52 · Reduced service | $26.30 | $26.30 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | 53 · Discontinued | $10.47 | $10.47 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $58.88 | Professional | 54 · Surgery only | $38.90 | $38.90 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $11.75 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $26.30 Typical High $38.90 | Professional | 52 · Reduced service | $26.30 | $26.30 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.47 Typical High $15.49 | Professional | 53 · Discontinued | $10.47 | $10.47 | $15.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $38.90 Typical High $58.88 | Professional | 54 · Surgery only | $38.90 | $38.90 | $58.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $11.75 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.25 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.25 | $5.25 | $7.76 |
Where Maine sits
The same service costs 3.5 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
$72.44
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.