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 $45.71 Median $45.71 Typical High $79.43 | Facility | None | $45.71 | $45.71 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $131.83 | Professional | None | $45.71 | $79.43 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $91.20 | Professional | None | $41.69 | $61.66 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $69.18 Median $93.33 Typical High $134.90 | Professional | 50 · Both sides | $69.18 | $93.33 | $134.90 |
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 $61.66 Median $107.15 Typical High $173.78 | Professional | None | $61.66 | $107.15 | $173.78 |
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 $52.48 Median $93.33 Typical High $158.49 | Professional | None | $52.48 | $93.33 | $158.49 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $79.43 Typical High $131.83 | Professional | None | $45.71 | $79.43 | $131.83 |
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 $61.66 Median $93.33 Typical High $165.96 | Professional | None | $61.66 | $93.33 | $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 $22.91 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $22.91 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $9.12 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $33.88 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $6.76 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $7.94 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.91 Median $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $22.91 | $32.36 | $39.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $9.12 | $12.88 | $15.85 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $48.98 Typical High $58.88 | Professional | 54 · Surgery only | $33.88 | $48.98 | $58.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $9.77 Typical High $11.75 | Professional | 55 · Aftercare only | $6.76 | $9.77 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.57 | $6.46 | $7.94 |
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
$79.43
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.