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 $117.49 Median $134.90 Typical High $177.83 | Professional | None | $117.49 | $134.90 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $204.17 | Professional | None | $100.00 | $134.90 | $204.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $204.17 Typical High $302.00 | Professional | 50 · Both sides | $154.88 | $204.17 | $302.00 |
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 $134.90 Median $186.21 Typical High $245.47 | Professional | None | $134.90 | $186.21 | $245.47 |
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 $114.82 Median $173.78 Typical High $288.40 | Professional | None | $114.82 | $173.78 | $288.40 |
Martin's Point Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $177.83 | Professional | None | $123.03 | $134.90 | $177.83 |
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 $107.15 Median $147.91 Typical High $234.42 | Professional | None | $107.15 | $147.91 | $234.42 |
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 $67.61 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $67.61 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $26.92 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $89.13 | Professional | 52 · Reduced service | $67.61 | $67.61 | $89.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $26.92 | $35.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $26.92 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $17.78 |
Where Maine sits
The same service costs 4.0 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· 31st of 51
$151
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.