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 $97.72 Median $97.72 Typical High $134.90 | Professional | None | $97.72 | $97.72 | $134.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $72.44 Median $97.72 Typical High $147.91 | Professional | None | $72.44 | $97.72 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | 50 · Both sides | $112.20 | $147.91 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $112.20 Typical High $707.95 | Facility | None | $56.23 | $112.20 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $177.83 | Professional | None | $102.33 | $138.04 | $177.83 |
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 $83.18 Median $114.82 Typical High $218.78 | Professional | None | $83.18 | $114.82 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $134.90 | Professional | None | $97.72 | $97.72 | $134.90 |
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 $75.86 Median $107.15 Typical High $151.36 | Professional | None | $75.86 | $107.15 | $151.36 |
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 $48.98 Median $48.98 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $48.98 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $26.92 | Professional | 53 · Discontinued | $19.50 | $19.50 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $48.98 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $48.98 | $67.61 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $26.92 | Professional | 53 · Discontinued | $19.50 | $19.50 | $26.92 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $19.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.49 |
Where Maine sits
The same service costs 3.8 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· 33rd of 51
$110
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.