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 $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $16.60 Typical High $22.39 | Professional | None | $10.47 | $16.60 | $22.39 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $15.49 Median $25.12 Typical High $33.11 | Professional | 50 · Both sides | $15.49 | $25.12 | $33.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $6.46 Median $10.47 Typical High $14.13 | Professional | 62 · Two surgeons | $6.46 | $10.47 | $14.13 |
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 $15.85 Median $17.38 Typical High $26.30 | Professional | None | $15.85 | $17.38 | $26.30 |
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 $12.88 Median $17.78 Typical High $22.91 | Professional | None | $12.88 | $17.78 | $22.91 |
Martin's Point Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
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 $14.13 Median $19.50 Typical High $23.44 | Professional | None | $14.13 | $19.50 | $23.44 |
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 $6.31 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $1.26 |
Where Maine sits
The same service costs 12.3 times more in Florida 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· 35th of 51
$17.38
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.