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 $48.98 Median $77.62 Typical High $128.82 | Professional | None | $48.98 | $77.62 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $151.36 | Professional | None | $50.12 | $87.10 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $83.18 Median $134.90 Typical High $223.87 | Professional | 50 · Both sides | $83.18 | $134.90 | $223.87 |
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 $66.07 Median $102.33 Typical High $177.83 | Professional | None | $66.07 | $102.33 | $177.83 |
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 $54.95 Median $97.72 Typical High $158.49 | Professional | None | $54.95 | $97.72 | $158.49 |
Martin's Point Setting Professional Modifier None Typical Low $48.98 Median $77.62 Typical High $128.82 | Professional | None | $48.98 | $77.62 | $128.82 |
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 $67.61 Median $102.33 Typical High $181.97 | Professional | None | $67.61 | $102.33 | $181.97 |
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 $24.55 Median $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $24.55 | $35.48 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $14.13 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $37.15 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $7.41 | $10.72 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $7.08 | $7.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $35.48 Typical High $38.02 | Professional | 52 · Reduced service | $24.55 | $35.48 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $14.13 Typical High $15.49 | Professional | 53 · Discontinued | $9.77 | $14.13 | $15.49 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $53.70 Typical High $57.54 | Professional | 54 · Surgery only | $37.15 | $53.70 | $57.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $10.72 Typical High $11.48 | Professional | 55 · Aftercare only | $7.41 | $10.72 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $7.08 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.90 | $7.08 | $7.76 |
Where Maine sits
The same service costs 3.2 times more in Wisconsin 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· 40th of 51
$85.11
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.