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 $426.58 Median $436.52 Typical High $436.52 | Professional | None | $426.58 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $707.95 | Professional | None | $338.84 | $501.19 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,202.26 Typical High $1,862.09 | Facility | None | $707.95 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $512.86 Typical High $776.25 | Professional | None | $467.74 | $512.86 | $776.25 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $363.08 Median $467.74 Typical High $691.83 | Professional | None | $363.08 | $467.74 | $691.83 |
Martin's Point Setting Professional Modifier None Typical Low $426.58 Median $436.52 Typical High $436.52 | Professional | None | $426.58 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,778.28 Typical High $3,311.31 | Facility | None | $1,071.52 | $1,778.28 | $3,311.31 |
United Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $707.95 | Professional | None | $354.81 | $501.19 | $707.95 |
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 $213.80 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $213.80 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $213.80 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $213.80 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $85.11 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 54 · Surgery only | $316.23 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $42.66 | $43.65 | $43.65 |
Where Maine sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 28th of 51
$479
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.