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 $102.33 Median $812.83 Typical High $1,174.90 | Professional | None | $102.33 | $812.83 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $338.84 Typical High $1,698.24 | Professional | None | $97.72 | $338.84 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $891.25 Typical High $1,412.54 | Facility | None | $537.03 | $891.25 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $323.59 Typical High $1,737.80 | Professional | None | $117.49 | $323.59 | $1,737.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $602.56 Typical High $1,949.84 | Professional | None | $100.00 | $602.56 | $1,949.84 |
Martin's Point Setting Professional Modifier None Typical Low $102.33 Median $812.83 Typical High $1,174.90 | Professional | None | $102.33 | $812.83 | $1,174.90 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $85.11 Median $338.84 Typical High $1,621.81 | Professional | None | $85.11 | $338.84 | $1,621.81 |
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 $51.29 Median $407.38 Typical High $588.84 | Professional | 52 · Reduced service | $51.29 | $407.38 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $162.18 Typical High $234.42 | Professional | 53 · Discontinued | $20.42 | $162.18 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $602.56 Typical High $870.96 | Professional | 54 · Surgery only | $75.86 | $602.56 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $120.23 Typical High $173.78 | Professional | 55 · Aftercare only | $15.49 | $120.23 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $81.28 Typical High $117.49 | Professional | 56 · Pre-op care only | $10.23 | $81.28 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $407.38 Typical High $588.84 | Professional | 52 · Reduced service | $51.29 | $407.38 | $588.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $162.18 Typical High $234.42 | Professional | 53 · Discontinued | $20.42 | $162.18 | $234.42 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $602.56 Typical High $870.96 | Professional | 54 · Surgery only | $75.86 | $602.56 | $870.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $120.23 Typical High $173.78 | Professional | 55 · Aftercare only | $15.49 | $120.23 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $95.50 Typical High $117.49 | Professional | 56 · Pre-op care only | $10.23 | $95.50 | $117.49 |
Where Maine sits
The same service costs 14.1 times more in Washington 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· 28th of 51
$724
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.