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 $138.04 Median $245.47 Typical High $302.00 | Professional | None | $138.04 | $245.47 | $302.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $251.19 | Professional | None | $100.00 | $165.96 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $549.54 | Professional | None | $147.91 | $316.23 | $549.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $125.89 Median $263.03 Typical High $457.09 | Professional | None | $125.89 | $263.03 | $457.09 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $302.00 | Professional | None | $141.25 | $245.47 | $302.00 |
United Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $426.58 | Professional | None | $151.36 | $257.04 | $426.58 |
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 $69.18 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $69.18 | $93.33 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $37.15 Typical High $60.26 | Professional | 53 · Discontinued | $27.54 | $37.15 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $141.25 Typical High $229.09 | Professional | 54 · Surgery only | $104.71 | $141.25 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $20.89 | $28.18 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $18.62 Typical High $30.20 | Professional | 56 · Pre-op care only | $13.80 | $18.62 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $93.33 Typical High $151.36 | Professional | 52 · Reduced service | $70.79 | $93.33 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $37.15 Typical High $60.26 | Professional | 53 · Discontinued | $28.18 | $37.15 | $60.26 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $141.25 Typical High $229.09 | Professional | 54 · Surgery only | $107.15 | $141.25 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $28.18 Typical High $45.71 | Professional | 55 · Aftercare only | $21.38 | $28.18 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.62 Typical High $30.20 | Professional | 56 · Pre-op care only | $14.13 | $18.62 | $30.20 |
Where Maine sits
The same service costs 3.4 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· 44th of 51
$209
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.