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 $60.26 Median $77.62 Typical High $77.62 | Professional | None | $60.26 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $97.72 | Professional | None | $46.77 | $69.18 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $457.09 Typical High $1,412.54 | Facility | None | $281.84 | $457.09 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $74.13 Typical High $109.65 | Professional | None | $66.07 | $74.13 | $109.65 |
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 $52.48 Median $67.61 Typical High $97.72 | Professional | None | $52.48 | $67.61 | $97.72 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | None | $60.26 | $77.62 | $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 $51.29 Median $77.62 Typical High $102.33 | Professional | None | $51.29 | $77.62 | $102.33 |
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 $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 54 · Surgery only | $45.71 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $7.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $12.02 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $58.88 Typical High $58.88 | Professional | 54 · Surgery only | $45.71 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $9.12 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $7.76 |
Where Maine sits
The same service costs 4.2 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· 21st of 51
$74.13
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.