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 Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $457.09 | Facility | None | $72.44 | $72.44 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $457.09 | Professional | None | $51.29 | $114.82 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $181.97 Typical High $436.52 | Professional | None | $51.29 | $181.97 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $79.43 Median $275.42 Typical High $676.08 | Professional | 50 · Both sides | $79.43 | $275.42 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $309.03 Typical High $549.54 | Professional | None | $60.26 | $309.03 | $549.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $257.04 Typical High $512.86 | Professional | None | $51.29 | $257.04 | $512.86 |
Martin's Point Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $457.09 | Professional | None | $51.29 | $114.82 | $457.09 |
United Setting Professional Modifier None Typical Low $60.26 Median $181.97 Typical High $537.03 | Professional | None | $60.26 | $181.97 | $537.03 |
10 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 $26.92 Median $36.31 Typical High $229.09 | Professional | 52 · Reduced service | $26.92 | $36.31 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $14.45 Typical High $91.20 | Professional | 53 · Discontinued | $10.72 | $14.45 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $53.70 Typical High $338.84 | Professional | 54 · Surgery only | $40.74 | $53.70 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.96 Typical High $67.61 | Professional | 55 · Aftercare only | $8.13 | $10.96 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $7.24 Typical High $45.71 | Professional | 56 · Pre-op care only | $5.37 | $7.24 | $45.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $36.31 Typical High $229.09 | Professional | 52 · Reduced service | $31.62 | $36.31 | $229.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.45 Typical High $91.20 | Professional | 53 · Discontinued | $12.59 | $14.45 | $91.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $53.70 Typical High $338.84 | Professional | 54 · Surgery only | $53.70 | $53.70 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $35.48 Typical High $67.61 | Professional | 55 · Aftercare only | $10.96 | $35.48 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $34.67 Typical High $45.71 | Professional | 56 · Pre-op care only | $7.24 | $34.67 | $45.71 |
Where Maine sits
The same service costs 4.9 times more in Iowa than in Nebraska. 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· 44th of 51
$182
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.