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 $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $67.61 Typical High $89.13 | Professional | None | $40.74 | $67.61 | $89.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $100.00 Typical High $134.90 | Professional | 50 · Both sides | $60.26 | $100.00 | $134.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $26.30 Median $41.69 Typical High $56.23 | Professional | 62 · Two surgeons | $26.30 | $41.69 | $56.23 |
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 $63.10 Median $69.18 Typical High $104.71 | Professional | None | $63.10 | $69.18 | $104.71 |
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 $50.12 Median $70.79 Typical High $91.20 | Professional | None | $50.12 | $70.79 | $91.20 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $53.70 Median $75.86 Typical High $93.33 | Professional | None | $53.70 | $75.86 | $93.33 |
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 $25.12 Median $25.12 Typical High $25.12 | Professional | 52 · Reduced service | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Where Maine sits
The same service costs 4.7 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
$69.18
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.