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 $53.70 Median $54.95 Typical High $77.62 | Professional | None | $53.70 | $54.95 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $85.11 | Professional | None | $41.69 | $56.23 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $63.10 Typical High $707.95 | Facility | None | $44.67 | $63.10 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $102.33 | Professional | None | $60.26 | $83.18 | $102.33 |
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 $47.86 Median $74.13 Typical High $128.82 | Professional | None | $47.86 | $74.13 | $128.82 |
Martin's Point Setting Professional Modifier None Typical Low $54.95 Median $58.88 Typical High $77.62 | Professional | None | $54.95 | $58.88 | $77.62 |
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 $43.65 Median $63.10 Typical High $107.15 | Professional | None | $43.65 | $63.10 | $107.15 |
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 $27.54 Median $27.54 Typical High $38.90 | Professional | 52 · Reduced service | $27.54 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $15.49 | Professional | 53 · Discontinued | $10.96 | $10.96 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $27.54 Typical High $38.90 | Professional | 52 · Reduced service | $27.54 | $27.54 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $15.49 | Professional | 53 · Discontinued | $10.96 | $10.96 | $15.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $11.75 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $7.76 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $7.76 |
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· 35th of 51
$64.57
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.