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 $186.21 Median $199.53 Typical High $199.53 | Professional | None | $186.21 | $199.53 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $338.84 | Professional | None | $158.49 | $234.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $223.87 Typical High $436.52 | Facility | None | $186.21 | $223.87 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $380.19 | Professional | None | $190.55 | $218.78 | $380.19 |
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 $199.53 Median $257.04 Typical High $323.59 | Professional | None | $199.53 | $257.04 | $323.59 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $199.53 | Professional | None | $186.21 | $199.53 | $199.53 |
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 $199.53 Median $275.42 Typical High $346.74 | Professional | None | $199.53 | $275.42 | $346.74 |
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 $100.00 Median $100.00 Typical High $100.00 | Professional | 52 · Reduced service | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | 53 · Discontinued | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | 54 · Surgery only | $151.36 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | 55 · Aftercare only | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 56 · Pre-op care only | $19.95 | $19.95 | $19.95 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 31st of 51
$234
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.