How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $371.54 Median $630.96 Typical High $3,801.89 | Professional | None | $371.54 | $630.96 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $1,412.54 Typical High $3,890.45 | Professional | None | $407.38 | $1,412.54 | $3,890.45 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $2,137.96 Typical High $5,888.44 | Professional | 50 · Both sides | $630.96 | $2,137.96 | $5,888.44 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,698.24 Typical High $3,890.45 | Professional | None | $457.09 | $1,698.24 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $1,819.70 Typical High $4,365.16 | Professional | None | $407.38 | $1,819.70 | $4,365.16 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $630.96 Typical High $3,801.89 | Professional | None | $354.81 | $630.96 | $3,801.89 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,288.25 Typical High $3,630.78 | Professional | None | $457.09 | $1,288.25 | $3,630.78 |
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 $208.93 Median $269.15 Typical High $1,584.89 | Professional | 52 · Reduced service | $208.93 | $269.15 | $1,584.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $107.15 Typical High $630.96 | Professional | 53 · Discontinued | $83.18 | $107.15 | $630.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $2,398.83 | Professional | 54 · Surgery only | $309.03 | $398.11 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $81.28 Typical High $478.63 | Professional | 55 · Aftercare only | $63.10 | $81.28 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $53.70 Typical High $316.23 | Professional | 56 · Pre-op care only | $41.69 | $53.70 | $316.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $269.15 Typical High $1,584.89 | Professional | 52 · Reduced service | $239.88 | $269.15 | $1,584.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $107.15 Typical High $630.96 | Professional | 53 · Discontinued | $95.50 | $107.15 | $630.96 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $2,398.83 | Professional | 54 · Surgery only | $398.11 | $398.11 | $2,398.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $478.63 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $478.63 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $53.70 Typical High $316.23 | Professional | 56 · Pre-op care only | $47.86 | $53.70 | $316.23 |
Where Maine sits
The same service costs 6.3 times more in Washington than in Maryland. 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· 43rd of 51
$1,413
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.