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 $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $794.33 Typical High $1,047.13 | Professional | None | $489.78 | $794.33 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $741.31 Median $1,174.90 Typical High $1,584.89 | Professional | 50 · Both sides | $741.31 | $1,174.90 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,623.41 Typical High $8,912.51 | Facility | None | $707.95 | $5,623.41 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $758.58 Typical High $1,230.27 | Professional | None | $741.31 | $758.58 | $1,230.27 |
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 $602.56 Median $812.83 Typical High $1,047.13 | Professional | None | $602.56 | $812.83 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $724.44 | Professional | None | $724.44 | $724.44 | $724.44 |
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 $645.65 Median $891.25 Typical High $1,096.48 | Professional | None | $645.65 | $891.25 | $1,096.48 |
5 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 $363.08 Median $363.08 Typical High $363.08 | Professional | 52 · Reduced service | $363.08 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | 53 · Discontinued | $144.54 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $537.03 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 56 · Pre-op care only | $72.44 | $72.44 | $72.44 |
Where Maine sits
The same service costs 3.9 times more in Alaska than in New York. 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· 32nd of 51
$794
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.