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 $389.05 Median $524.81 Typical High $933.25 | Professional | None | $389.05 | $524.81 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $602.56 Typical High $1,071.52 | Professional | None | $407.38 | $602.56 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $707.95 Typical High $2,290.87 | Facility | None | $691.83 | $707.95 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $1,047.13 | Professional | None | $467.74 | $616.60 | $1,047.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $467.74 Median $676.08 Typical High $1,096.48 | Professional | None | $467.74 | $676.08 | $1,096.48 |
Martin's Point Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $933.25 | Professional | None | $398.11 | $524.81 | $933.25 |
United Setting Facility Modifier None Typical Low $776.25 Median $812.83 Typical High $1,202.26 | Facility | None | $776.25 | $812.83 | $1,202.26 |
United Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $912.01 | Professional | None | $446.68 | $602.56 | $912.01 |
6 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 $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $52.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $199.53 Typical High $263.03 | Professional | 52 · Reduced service | $199.53 | $199.53 | $263.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $60.26 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $60.26 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $39.81 Typical High $52.48 | Professional | 56 · Pre-op care only | $39.81 | $39.81 | $52.48 |
Where Maine sits
The same service costs 3.1 times more in Alaska than in Indiana. 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· 19th of 51
$603
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.