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 $186.21 Median $239.88 Typical High $398.11 | Professional | None | $186.21 | $239.88 | $398.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $204.17 Typical High $346.74 | Professional | None | $134.90 | $204.17 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $660.69 | Professional | None | $186.21 | $407.38 | $660.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $346.74 Typical High $645.65 | Professional | None | $165.96 | $346.74 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $398.11 | Professional | None | $186.21 | $239.88 | $398.11 |
United Setting Professional Modifier None Typical Low $186.21 Median $323.59 Typical High $562.34 | Professional | None | $186.21 | $323.59 | $562.34 |
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 $93.33 Median $120.23 Typical High $199.53 | Professional | 52 · Reduced service | $93.33 | $120.23 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $47.86 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $141.25 | $177.83 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $58.88 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $120.23 Typical High $199.53 | Professional | 52 · Reduced service | $93.33 | $120.23 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $47.86 Typical High $79.43 | Professional | 53 · Discontinued | $37.15 | $47.86 | $79.43 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $177.83 Typical High $295.12 | Professional | 54 · Surgery only | $141.25 | $177.83 | $295.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $36.31 Typical High $58.88 | Professional | 55 · Aftercare only | $28.18 | $36.31 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $23.99 Typical High $39.81 | Professional | 56 · Pre-op care only | $18.62 | $23.99 | $39.81 |
Where Maine sits
The same service costs 3.5 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
$269
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.