How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $85.11 Median $120.23 Typical High $138.04 | Professional | None | $85.11 | $120.23 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $223.87 | Professional | None | $79.43 | $125.89 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $263.03 | Professional | None | $93.33 | $158.49 | $263.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $77.62 Median $128.82 Typical High $223.87 | Professional | None | $77.62 | $128.82 | $223.87 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $138.04 | Professional | None | $91.20 | $120.23 | $138.04 |
United Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $208.93 | Professional | None | $72.44 | $120.23 | $208.93 |
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 $42.66 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $42.66 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.95 Typical High $27.54 | Professional | 53 · Discontinued | $16.98 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $64.57 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.14 Typical High $20.89 | Professional | 55 · Aftercare only | $12.88 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $44.67 | $50.12 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.95 Typical High $27.54 | Professional | 53 · Discontinued | $18.20 | $19.95 | $27.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $67.61 | $75.86 | $104.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.14 Typical High $20.89 | Professional | 55 · Aftercare only | $13.49 | $15.14 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.12 | $10.00 | $13.80 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 27th of 51
$126
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.