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 $46.77 Median $74.13 Typical High $151.36 | Professional | None | $46.77 | $74.13 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $37.15 Median $66.07 Typical High $95.50 | Professional | None | $37.15 | $66.07 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $165.96 Typical High $1,412.54 | Facility | None | $74.13 | $165.96 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $114.82 Typical High $181.97 | Professional | None | $60.26 | $114.82 | $181.97 |
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 $48.98 Median $100.00 Typical High $177.83 | Professional | None | $48.98 | $100.00 | $177.83 |
Martin's Point Setting Professional Modifier None Typical Low $46.77 Median $74.13 Typical High $151.36 | Professional | None | $46.77 | $74.13 | $151.36 |
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 $64.57 Median $100.00 Typical High $165.96 | Professional | None | $64.57 | $100.00 | $165.96 |
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 $23.44 Median $28.18 Typical High $47.86 | Professional | 52 · Reduced service | $23.44 | $28.18 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $19.05 | Professional | 53 · Discontinued | $9.33 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $41.69 Typical High $72.44 | Professional | 54 · Surgery only | $34.67 | $41.69 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $14.45 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $9.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $28.18 Typical High $47.86 | Professional | 52 · Reduced service | $23.44 | $28.18 | $47.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $11.22 Typical High $19.05 | Professional | 53 · Discontinued | $9.33 | $11.22 | $19.05 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $41.69 Typical High $72.44 | Professional | 54 · Surgery only | $34.67 | $41.69 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $8.32 Typical High $14.45 | Professional | 55 · Aftercare only | $6.92 | $8.32 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.62 Typical High $9.55 | Professional | 56 · Pre-op care only | $4.68 | $5.62 | $9.55 |
Where Maine sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 48th of 51
$83.18
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.