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 $85.11 Median $104.71 Typical High $173.78 | Professional | None | $85.11 | $104.71 | $173.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $89.13 Typical High $131.83 | Professional | None | $66.07 | $89.13 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $134.90 Typical High $194.98 | Professional | 50 · Both sides | $100.00 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $120.23 Typical High $707.95 | Facility | None | $56.23 | $120.23 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $158.49 | Professional | None | $93.33 | $125.89 | $158.49 |
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 $75.86 Median $114.82 Typical High $199.53 | Professional | None | $75.86 | $114.82 | $199.53 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $120.23 Typical High $173.78 | Professional | None | $85.11 | $120.23 | $173.78 |
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 $69.18 Median $95.50 Typical High $158.49 | Professional | None | $69.18 | $95.50 | $158.49 |
8 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 $42.66 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $42.66 | $42.66 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $16.98 | $16.98 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $12.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $42.66 Typical High $60.26 | Professional | 52 · Reduced service | $42.66 | $42.66 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $23.99 | Professional | 53 · Discontinued | $16.98 | $16.98 | $23.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $12.88 Typical High $17.78 | Professional | 55 · Aftercare only | $12.88 | $12.88 | $17.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $12.02 |
Where Maine sits
The same service costs 3.6 times more in Alaska 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· 30th of 51
$105
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.