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 $95.50 Median $95.50 Typical High $234.42 | Facility | None | $95.50 | $95.50 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $234.42 | Professional | None | $75.86 | $144.54 | $234.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $194.98 | Professional | None | $61.66 | $102.33 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $151.36 Typical High $204.17 | Professional | 50 · Both sides | $104.71 | $151.36 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $229.09 Typical High $371.54 | Professional | None | $102.33 | $229.09 | $371.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $190.55 Typical High $354.81 | Professional | None | $75.86 | $190.55 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $234.42 | Professional | None | $79.43 | $144.54 | $234.42 |
United Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $316.23 | Professional | None | $89.13 | $177.83 | $316.23 |
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 $38.02 Median $47.86 Typical High $117.49 | Professional | 52 · Reduced service | $38.02 | $47.86 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.05 Typical High $46.77 | Professional | 53 · Discontinued | $15.14 | $19.05 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $70.79 Typical High $177.83 | Professional | 54 · Surgery only | $57.54 | $70.79 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.13 Typical High $35.48 | Professional | 55 · Aftercare only | $11.48 | $14.13 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $23.44 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $23.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $47.86 Typical High $117.49 | Professional | 52 · Reduced service | $43.65 | $47.86 | $117.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $46.77 | Professional | 53 · Discontinued | $17.38 | $19.05 | $46.77 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $70.79 Typical High $177.83 | Professional | 54 · Surgery only | $70.79 | $70.79 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $14.13 Typical High $35.48 | Professional | 55 · Aftercare only | $13.18 | $14.13 | $35.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.55 Typical High $23.44 | Professional | 56 · Pre-op care only | $8.71 | $9.55 | $23.44 |
Where Maine sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 49th of 51
$129
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.