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 $128.82 Median $147.91 Typical High $190.55 | Professional | None | $128.82 | $147.91 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $257.04 | Professional | None | $117.49 | $173.78 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $2,344.23 Typical High $3,235.94 | Facility | None | $1,148.15 | $2,344.23 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $162.18 Typical High $288.40 | Professional | None | $141.25 | $162.18 | $288.40 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $245.47 | Professional | None | $147.91 | $190.55 | $245.47 |
Martin's Point Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $190.55 | Professional | None | $131.83 | $147.91 | $190.55 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $2,238.72 Typical High $3,890.45 | Facility | None | $1,513.56 | $2,238.72 | $3,890.45 |
United Setting Professional Modifier None Typical Low $162.18 Median $194.98 Typical High $257.04 | Professional | None | $162.18 | $194.98 | $257.04 |
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 $112.20 Median $112.20 Typical High $112.20 | Professional | 54 · Surgery only | $112.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $22.39 | $22.39 | $22.39 |
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 10.7 times more in Oklahoma 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· 37th of 51
$178
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.