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 $181.97 Median $229.09 Typical High $489.78 | Professional | None | $181.97 | $229.09 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $562.34 | Professional | None | $123.03 | $251.19 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $380.19 Typical High $831.76 | Professional | 50 · Both sides | $199.53 | $380.19 | $831.76 |
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 $371.54 Typical High $562.34 | Professional | None | $190.55 | $371.54 | $562.34 |
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 $309.03 Typical High $588.84 | Professional | None | $173.78 | $309.03 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $489.78 | Professional | None | $177.83 | $229.09 | $489.78 |
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 $309.03 Typical High $512.86 | Professional | None | $190.55 | $309.03 | $512.86 |
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 $154.88 Median $154.88 Typical High $371.54 | Professional | 54 · Surgery only | $154.88 | $154.88 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $48.98 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $371.54 | Professional | 54 · Surgery only | $154.88 | $154.88 | $371.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $74.13 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $74.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $48.98 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $48.98 |
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· 47th of 51
$282
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.