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 $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $112.20 Typical High $147.91 | Professional | None | $69.18 | $112.20 | $147.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $104.71 Median $165.96 Typical High $223.87 | Professional | 50 · Both sides | $104.71 | $165.96 | $223.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $43.65 Median $70.79 Typical High $93.33 | Professional | 62 · Two surgeons | $43.65 | $70.79 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $1,412.54 | Facility | None | $691.83 | $707.95 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $173.78 | Professional | None | $104.71 | $114.82 | $173.78 |
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 $83.18 Median $117.49 Typical High $151.36 | Professional | None | $83.18 | $117.49 | $151.36 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
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 $89.13 Median $125.89 Typical High $154.88 | Professional | None | $89.13 | $125.89 | $154.88 |
4 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 $41.69 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $8.32 |
Where Maine sits
The same service costs 4.5 times more in Alaska 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· 29th of 51
$115
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.