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 $134.90 Median $147.91 Typical High $154.88 | Professional | None | $134.90 | $147.91 | $154.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $245.47 | Professional | None | $134.90 | $177.83 | $245.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $85.11 Median $112.20 Typical High $154.88 | Professional | 62 · Two surgeons | $85.11 | $112.20 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $676.08 Typical High $1,412.54 | Facility | None | $537.03 | $676.08 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $323.59 | Professional | None | $186.21 | $199.53 | $323.59 |
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 $147.91 Median $204.17 Typical High $269.15 | Professional | None | $147.91 | $204.17 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $147.91 | Professional | None | $134.90 | $147.91 | $147.91 |
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 $147.91 Median $218.78 Typical High $323.59 | Professional | None | $147.91 | $218.78 | $323.59 |
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 $74.13 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $74.13 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $29.51 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 54 · Surgery only | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $14.79 | $14.79 | $14.79 |
Where Maine sits
The same service costs 4.3 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· 43rd of 51
$186
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.