How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $194.98 Median $245.47 Typical High $416.87 | Professional | None | $194.98 | $245.47 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $389.05 | Professional | None | $144.54 | $223.87 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $724.44 | Professional | None | $199.53 | $446.68 | $724.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $363.08 Typical High $707.95 | Professional | None | $177.83 | $363.08 | $707.95 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $416.87 | Professional | None | $194.98 | $245.47 | $416.87 |
United Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $602.56 | Professional | None | $194.98 | $338.84 | $602.56 |
10 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 $97.72 Median $123.03 Typical High $208.93 | Professional | 52 · Reduced service | $97.72 | $123.03 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $38.90 | $50.12 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $316.23 | Professional | 54 · Surgery only | $147.91 | $186.21 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $63.10 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $41.69 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $123.03 Typical High $208.93 | Professional | 52 · Reduced service | $97.72 | $123.03 | $208.93 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $50.12 Typical High $83.18 | Professional | 53 · Discontinued | $38.90 | $50.12 | $83.18 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $186.21 Typical High $316.23 | Professional | 54 · Surgery only | $147.91 | $186.21 | $316.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $37.15 Typical High $63.10 | Professional | 55 · Aftercare only | $29.51 | $37.15 | $63.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $24.55 Typical High $41.69 | Professional | 56 · Pre-op care only | $19.50 | $24.55 | $41.69 |
Where Maine sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 42nd of 51
$295
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.