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 $70.79 Median $95.50 Typical High $158.49 | Professional | None | $70.79 | $95.50 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $104.71 | Professional | None | $51.29 | $64.57 | $104.71 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $104.71 Typical High $154.88 | Professional | 50 · Both sides | $79.43 | $104.71 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $85.11 Typical High $707.95 | Facility | None | $56.23 | $85.11 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $151.36 | Professional | None | $72.44 | $104.71 | $151.36 |
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 $63.10 Median $95.50 Typical High $154.88 | Professional | None | $63.10 | $95.50 | $154.88 |
Martin's Point Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $158.49 | Professional | None | $70.79 | $95.50 | $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 $56.23 Median $79.43 Typical High $131.83 | Professional | None | $56.23 | $79.43 | $131.83 |
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 $34.67 Median $34.67 Typical High $47.86 | Professional | 52 · Reduced service | $34.67 | $34.67 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $14.13 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $9.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $47.86 | Professional | 52 · Reduced service | $34.67 | $34.67 | $47.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $19.05 | Professional | 53 · Discontinued | $14.13 | $14.13 | $19.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $9.55 |
Where Maine sits
The same service costs 3.5 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· 32nd 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.