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 Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Facility | None | $93.33 | $93.33 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $204.17 | Professional | None | $93.33 | $123.03 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $134.90 Typical High $239.88 | Professional | None | $89.13 | $134.90 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $177.83 Typical High $1,412.54 | Facility | None | $77.62 | $177.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $239.88 | Professional | None | $123.03 | $173.78 | $239.88 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $239.88 | Professional | None | $102.33 | $154.88 | $239.88 |
Martin's Point Setting Professional Modifier None Typical Low $93.33 Median $123.03 Typical High $204.17 | Professional | None | $93.33 | $123.03 | $204.17 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $114.82 Median $151.36 Typical High $213.80 | Professional | None | $114.82 | $151.36 | $213.80 |
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 $45.71 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $69.18 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $12.30 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $45.71 | $48.98 | $60.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $18.62 | $19.95 | $24.55 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $69.18 | $74.13 | $91.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $13.80 | $14.79 | $18.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $9.33 | $10.00 | $12.30 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 30th of 51
$135
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.