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 $15.14 Median $23.99 Typical High $45.71 | Facility | None | $15.14 | $23.99 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $45.71 | Professional | None | $16.98 | $26.30 | $45.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $28.18 Typical High $51.29 | Professional | None | $14.13 | $28.18 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $56.23 Typical High $707.95 | Facility | None | $38.90 | $56.23 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $34.67 Typical High $52.48 | Professional | None | $20.89 | $34.67 | $52.48 |
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 $18.62 Median $29.51 Typical High $52.48 | Professional | None | $18.62 | $29.51 | $52.48 |
Martin's Point Setting Facility Modifier None Typical Low $15.14 Median $23.99 Typical High $45.71 | Facility | None | $15.14 | $23.99 | $45.71 |
Martin's Point Setting Professional Modifier None Typical Low $16.98 Median $26.30 Typical High $45.71 | Professional | None | $16.98 | $26.30 | $45.71 |
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 $20.89 Median $29.51 Typical High $52.48 | Professional | None | $20.89 | $29.51 | $52.48 |
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 $12.02 Median $12.02 Typical High $22.91 | Professional | 52 · Reduced service | $12.02 | $12.02 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $9.12 | Professional | 53 · Discontinued | $4.79 | $4.79 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $17.78 Typical High $34.67 | Professional | 54 · Surgery only | $17.78 | $17.78 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $6.92 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $4.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.02 Typical High $22.91 | Professional | 52 · Reduced service | $12.02 | $12.02 | $22.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $9.12 | Professional | 53 · Discontinued | $4.79 | $4.79 | $9.12 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $17.78 Typical High $34.67 | Professional | 54 · Surgery only | $17.78 | $17.78 | $34.67 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $6.92 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $6.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.40 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.40 | $2.40 | $4.57 |
Where Maine sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 43rd of 51
$29.51
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.