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 $107.15 Median $158.49 Typical High $177.83 | Professional | None | $107.15 | $158.49 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $190.55 | Professional | None | $87.10 | $131.83 | $190.55 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $204.17 Typical High $288.40 | Professional | 50 · Both sides | $141.25 | $204.17 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $229.09 | Professional | None | $141.25 | $177.83 | $229.09 |
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 $104.71 Median $144.54 Typical High $204.17 | Professional | None | $104.71 | $144.54 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $177.83 | Professional | None | $107.15 | $158.49 | $177.83 |
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 $102.33 Median $151.36 Typical High $204.17 | Professional | None | $102.33 | $151.36 | $204.17 |
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 $79.43 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $31.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $117.49 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 52 · Reduced service | $79.43 | $79.43 | $89.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $31.62 | $31.62 | $35.48 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $117.49 | $117.49 | $134.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $17.78 |
Where Maine sits
The same service costs 4.5 times more in Alaska than in Florida. 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· 18th of 51
$155
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.