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 $269.15 Median $316.23 Typical High $389.05 | Professional | None | $269.15 | $316.23 | $389.05 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $426.58 Typical High $758.58 | Professional | None | $288.40 | $426.58 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $269.15 Typical High $478.63 | Professional | 62 · Two surgeons | $186.21 | $269.15 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $4,168.69 | Facility | None | $707.95 | $2,570.40 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $851.14 | Professional | None | $389.05 | $549.54 | $851.14 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $758.58 | Professional | None | $295.12 | $489.78 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $389.05 | Professional | None | $269.15 | $316.23 | $389.05 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $724.44 | Professional | None | $371.54 | $501.19 | $724.44 |
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 $144.54 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $144.54 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | 53 · Discontinued | $57.54 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $218.78 | $218.78 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $38.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $144.54 Typical High $194.98 | Professional | 52 · Reduced service | $144.54 | $144.54 | $194.98 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $77.62 | Professional | 53 · Discontinued | $57.54 | $57.54 | $77.62 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $218.78 Typical High $288.40 | Professional | 54 · Surgery only | $218.78 | $218.78 | $288.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $43.65 Typical High $58.88 | Professional | 55 · Aftercare only | $43.65 | $43.65 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $38.90 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $38.90 |
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· 37th of 51
$437
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.