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 $380.19 Median $1,905.46 Typical High $3,715.35 | Professional | None | $380.19 | $1,905.46 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $1,412.54 Typical High $3,801.89 | Professional | None | $407.38 | $1,412.54 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $630.96 Median $2,089.30 Typical High $5,754.40 | Professional | 50 · Both sides | $630.96 | $2,089.30 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $1,659.59 Typical High $3,801.89 | Professional | None | $457.09 | $1,659.59 | $3,801.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $1,698.24 Typical High $4,168.69 | Professional | None | $407.38 | $1,698.24 | $4,168.69 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $1,905.46 Typical High $3,715.35 | Professional | None | $380.19 | $1,905.46 | $3,715.35 |
United Setting Professional Modifier None Typical Low $457.09 Median $1,202.26 Typical High $3,548.13 | Professional | None | $457.09 | $1,202.26 | $3,548.13 |
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 $263.03 Typical High $1,513.56 | Professional | 52 · Reduced service | $208.93 | $263.03 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $104.71 Typical High $602.56 | Professional | 53 · Discontinued | $83.18 | $104.71 | $602.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $398.11 Typical High $2,238.72 | Professional | 54 · Surgery only | $309.03 | $398.11 | $2,238.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $79.43 Typical High $446.68 | Professional | 55 · Aftercare only | $61.66 | $79.43 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $52.48 Typical High $302.00 | Professional | 56 · Pre-op care only | $41.69 | $52.48 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $1,513.56 | Professional | 52 · Reduced service | $239.88 | $263.03 | $1,513.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $602.56 | Professional | 53 · Discontinued | $95.50 | $104.71 | $602.56 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $398.11 Typical High $2,238.72 | Professional | 54 · Surgery only | $398.11 | $398.11 | $2,238.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $79.43 Typical High $446.68 | Professional | 55 · Aftercare only | $70.79 | $79.43 | $446.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $302.00 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $302.00 |
Where Maine sits
The same service costs 6.2 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· 33rd of 51
$1,698
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.