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 Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $38.02 | Facility | None | $29.51 | $29.51 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $54.95 | Professional | None | $29.51 | $38.02 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $32.36 Typical High $46.77 | Professional | None | $22.91 | $32.36 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $41.69 Typical High $1,862.09 | Facility | None | $18.62 | $41.69 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $39.81 Typical High $58.88 | Professional | None | $30.90 | $39.81 | $58.88 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $26.30 Median $41.69 Typical High $64.57 | Professional | None | $26.30 | $41.69 | $64.57 |
Martin's Point Setting Professional Modifier None Typical Low $29.51 Median $38.02 Typical High $54.95 | Professional | None | $29.51 | $38.02 | $54.95 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $25.70 Median $36.31 Typical High $63.10 | Professional | None | $25.70 | $36.31 | $63.10 |
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 $14.79 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $14.79 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.59 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $28.18 | Professional | 54 · Surgery only | $22.39 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $14.79 Typical High $19.05 | Professional | 52 · Reduced service | $14.79 | $14.79 | $19.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $5.89 Typical High $7.59 | Professional | 53 · Discontinued | $5.89 | $5.89 | $7.59 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $22.39 Typical High $28.18 | Professional | 54 · Surgery only | $22.39 | $22.39 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $5.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $2.95 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.95 | $2.95 | $3.80 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 36th of 51
$36.31
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.