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 $416.87 Median $416.87 Typical High $1,621.81 | Facility | None | $416.87 | $416.87 | $1,621.81 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $1,621.81 | Professional | None | $363.08 | $478.63 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $257.04 Median $741.31 Typical High $1,659.59 | Professional | None | $257.04 | $741.31 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $1,096.48 Typical High $2,511.89 | Professional | 50 · Both sides | $407.38 | $1,096.48 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,187.76 Typical High $5,754.40 | Facility | None | $812.83 | $2,187.76 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $1,202.26 Typical High $2,137.96 | Professional | None | $389.05 | $1,202.26 | $2,137.96 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $1,071.52 Typical High $1,949.84 | Professional | None | $363.08 | $1,071.52 | $1,949.84 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $478.63 Typical High $1,621.81 | Professional | None | $363.08 | $478.63 | $1,621.81 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $389.05 Median $1,230.27 Typical High $1,995.26 | Professional | None | $389.05 | $1,230.27 | $1,995.26 |
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 $316.23 Median $316.23 Typical High $1,230.27 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $245.47 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $162.18 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $162.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $316.23 Typical High $1,230.27 | Professional | 54 · Surgery only | $316.23 | $316.23 | $1,230.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $63.10 Typical High $245.47 | Professional | 55 · Aftercare only | $63.10 | $63.10 | $245.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $41.69 Typical High $162.18 | Professional | 56 · Pre-op care only | $41.69 | $41.69 | $162.18 |
Where Maine sits
The same service costs 4.8 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
$871
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.