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 $707.95 Median $954.99 Typical High $1,698.24 | Professional | None | $707.95 | $954.99 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $741.31 Median $1,096.48 Typical High $1,949.84 | Professional | None | $741.31 | $1,096.48 | $1,949.84 |
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 $851.14 Median $1,122.02 Typical High $1,949.84 | Professional | None | $851.14 | $1,122.02 | $1,949.84 |
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 $831.76 Median $1,202.26 Typical High $1,995.26 | Professional | None | $831.76 | $1,202.26 | $1,995.26 |
Martin's Point Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,698.24 | Professional | None | $707.95 | $954.99 | $1,698.24 |
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 $812.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $812.83 | $1,047.13 | $1,621.81 |
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 $354.81 Median $354.81 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $354.81 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $95.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $354.81 Median $354.81 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $354.81 | $467.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $141.25 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $141.25 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $70.79 Typical High $95.50 | Professional | 56 · Pre-op care only | $70.79 | $70.79 | $95.50 |
Where Maine sits
The same service costs 3.2 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· 21st of 51
$1,047
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.