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 $123.03 Median $169.82 Typical High $239.88 | Professional | None | $123.03 | $169.82 | $239.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $190.55 | Professional | None | $93.33 | $125.89 | $190.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $144.54 Median $190.55 Typical High $281.84 | Professional | 50 · Both sides | $144.54 | $190.55 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $154.88 Typical High $707.95 | Facility | None | $56.23 | $154.88 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $229.09 | Professional | None | $128.82 | $177.83 | $229.09 |
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 $109.65 Median $169.82 Typical High $275.42 | Professional | None | $109.65 | $169.82 | $275.42 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $239.88 | Professional | None | $125.89 | $169.82 | $239.88 |
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 $100.00 Median $141.25 Typical High $229.09 | Professional | None | $100.00 | $141.25 | $229.09 |
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 $63.10 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $63.10 | $85.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $25.12 | $33.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $25.70 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $25.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $16.98 |
Where Maine sits
The same service costs 3.7 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· 28th of 51
$148
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.