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 $52.48 Median $102.33 Typical High $102.33 | Facility | None | $52.48 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $158.49 | Professional | None | $52.48 | $83.18 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $58.88 Typical High $100.00 | Professional | None | $40.74 | $58.88 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $89.13 Typical High $128.82 | Professional | 50 · Both sides | $60.26 | $89.13 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $107.15 Typical High $707.95 | Facility | None | $56.23 | $107.15 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $91.20 Typical High $131.83 | Professional | None | $57.54 | $91.20 | $131.83 |
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 $46.77 Median $83.18 Typical High $169.82 | Professional | None | $46.77 | $83.18 | $169.82 |
Martin's Point Setting Facility Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $13,489.63 | Facility | None | $5,128.61 | $5,128.61 | $13,489.63 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $85.11 Typical High $158.49 | Professional | None | $52.48 | $85.11 | $158.49 |
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 $81.28 Typical High $134.90 | Professional | None | $41.69 | $81.28 | $134.90 |
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 $26.30 Median $30.20 Typical High $51.29 | Professional | 52 · Reduced service | $26.30 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.02 Typical High $20.42 | Professional | 53 · Discontinued | $10.47 | $12.02 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $9.12 Typical High $15.49 | Professional | 55 · Aftercare only | $7.94 | $9.12 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.03 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.25 | $6.03 | $10.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $28.84 Typical High $51.29 | Professional | 52 · Reduced service | $26.30 | $28.84 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $11.48 Typical High $20.42 | Professional | 53 · Discontinued | $10.47 | $11.48 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $15.49 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.75 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.25 | $5.75 | $10.23 |
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· 39th of 51
$77.62
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.