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 $79.43 Median $100.00 Typical High $114.82 | Professional | None | $79.43 | $100.00 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $204.17 | Professional | None | $83.18 | $114.82 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $239.88 | Professional | None | $107.15 | $144.54 | $239.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $134.90 Typical High $208.93 | Professional | None | $91.20 | $134.90 | $208.93 |
Martin's Point Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $114.82 | Professional | None | $79.43 | $100.00 | $114.82 |
United Setting Professional Modifier None Typical Low $87.10 Median $125.89 Typical High $186.21 | Professional | None | $87.10 | $125.89 | $186.21 |
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 $39.81 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $15.85 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $85.11 | Professional | 54 · Surgery only | $58.88 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $50.12 Typical High $56.23 | Professional | 52 · Reduced service | $39.81 | $50.12 | $56.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $22.91 | Professional | 53 · Discontinued | $15.85 | $19.95 | $22.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $85.11 | Professional | 54 · Surgery only | $58.88 | $74.13 | $85.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $15.14 Typical High $16.98 | Professional | 55 · Aftercare only | $11.75 | $15.14 | $16.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $11.48 |
Where Maine sits
The same service costs 3.8 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· 33rd of 51
$115
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.