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 $204.17 Median $204.17 Typical High $467.74 | Facility | None | $204.17 | $204.17 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $467.74 | Professional | None | $165.96 | $223.87 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $512.86 | Professional | None | $123.03 | $245.47 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $371.54 Typical High $776.25 | Professional | 50 · Both sides | $199.53 | $371.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $812.83 Typical High $2,290.87 | Facility | None | $691.83 | $812.83 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $346.74 Typical High $537.03 | Professional | None | $190.55 | $346.74 | $537.03 |
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 $173.78 Median $302.00 Typical High $524.81 | Professional | None | $173.78 | $302.00 | $524.81 |
Martin's Point Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $467.74 | Professional | None | $165.96 | $223.87 | $467.74 |
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 $190.55 Median $302.00 Typical High $489.78 | Professional | None | $190.55 | $302.00 | $489.78 |
6 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 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $346.74 | Professional | 54 · Surgery only | $151.36 | $151.36 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $70.79 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $46.77 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $46.77 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $346.74 | Professional | 54 · Surgery only | $151.36 | $151.36 | $346.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $70.79 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $70.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $46.77 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $46.77 |
Where Maine sits
The same service costs 3.4 times more in Alaska 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· 48th of 51
$263
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.