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 $24.55 Median $30.90 Typical High $44.67 | Professional | None | $24.55 | $30.90 | $44.67 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $25.70 Typical High $46.77 | Professional | None | $17.78 | $25.70 | $46.77 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $26.30 Median $38.90 Typical High $79.43 | Professional | 50 · Both sides | $26.30 | $38.90 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $41.69 Typical High $66.07 | Professional | None | $25.70 | $41.69 | $66.07 |
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 $19.05 Median $33.88 Typical High $66.07 | Professional | None | $19.05 | $33.88 | $66.07 |
Martin's Point Setting Professional Modifier None Typical Low $24.55 Median $36.31 Typical High $44.67 | Professional | None | $24.55 | $36.31 | $44.67 |
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 $19.50 Median $33.88 Typical High $52.48 | Professional | None | $19.50 | $33.88 | $52.48 |
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 $12.30 Median $14.13 Typical High $22.39 | Professional | 52 · Reduced service | $12.30 | $14.13 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.62 Typical High $8.91 | Professional | 53 · Discontinued | $4.90 | $5.62 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.27 Typical High $6.76 | Professional | 55 · Aftercare only | $3.72 | $4.27 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.82 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.45 | $2.82 | $4.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $14.13 Typical High $22.39 | Professional | 52 · Reduced service | $12.30 | $14.13 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.62 Typical High $8.91 | Professional | 53 · Discontinued | $4.90 | $5.62 | $8.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.27 Typical High $6.76 | Professional | 55 · Aftercare only | $3.72 | $4.27 | $6.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.82 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.45 | $2.82 | $4.47 |
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· 48th of 51
$30.90
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.