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 $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $645.65 | Professional | None | $302.00 | $478.63 | $645.65 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $724.44 Typical High $977.24 | Professional | 50 · Both sides | $457.09 | $724.44 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $2,290.87 Typical High $3,090.30 | Facility | None | $812.83 | $2,290.87 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $467.74 Typical High $758.58 | Professional | None | $457.09 | $467.74 | $758.58 |
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 $371.54 Median $489.78 Typical High $630.96 | Professional | None | $371.54 | $489.78 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $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 $436.52 Median $537.03 Typical High $676.08 | Professional | None | $436.52 | $537.03 | $676.08 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | 54 · Surgery only | $331.13 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Where Maine sits
The same service costs 4.7 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· 38th of 51
$490
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.