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 $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $100.00 Typical High $134.90 | Professional | None | $63.10 | $100.00 | $134.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $95.50 Median $151.36 Typical High $204.17 | Professional | 50 · Both sides | $95.50 | $151.36 | $204.17 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $39.81 Median $63.10 Typical High $85.11 | Professional | 62 · Two surgeons | $39.81 | $63.10 | $85.11 |
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 $93.33 Median $104.71 Typical High $158.49 | Professional | None | $93.33 | $104.71 | $158.49 |
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 $75.86 Median $104.71 Typical High $138.04 | Professional | None | $75.86 | $104.71 | $138.04 |
Martin's Point Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None | $75.86 | $75.86 | $75.86 |
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 $79.43 Median $114.82 Typical High $141.25 | Professional | None | $79.43 | $114.82 | $141.25 |
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 $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Maine sits
The same service costs 4.5 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· 31st of 51
$102
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.