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 $60.26 Median $66.07 Typical High $257.04 | Professional | None | $60.26 | $66.07 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $125.89 | Professional | None | $47.86 | $69.18 | $125.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $104.71 Typical High $144.54 | Professional | 50 · Both sides | $74.13 | $104.71 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $120.23 Typical High $323.59 | Professional | None | $67.61 | $120.23 | $323.59 |
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 $53.70 Median $154.88 Typical High $398.11 | Professional | None | $53.70 | $154.88 | $398.11 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $257.04 | Professional | None | $66.07 | $66.07 | $257.04 |
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 $52.48 Median $147.91 Typical High $269.15 | Professional | None | $52.48 | $147.91 | $269.15 |
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 $33.11 Median $33.11 Typical High $128.82 | Professional | 52 · Reduced service | $33.11 | $33.11 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $51.29 | Professional | 53 · Discontinued | $13.18 | $13.18 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $190.55 | Professional | 54 · Surgery only | $50.12 | $50.12 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $38.90 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $33.11 Typical High $128.82 | Professional | 52 · Reduced service | $33.11 | $33.11 | $128.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $51.29 | Professional | 53 · Discontinued | $13.18 | $13.18 | $51.29 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $190.55 | Professional | 54 · Surgery only | $50.12 | $50.12 | $190.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $38.90 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $38.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $25.70 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $25.70 |
Where Maine sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 47th of 51
$85.11
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.