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 $588.84 Median $588.84 Typical High $630.96 | Professional | None | $588.84 | $588.84 | $630.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $891.25 Typical High $1,230.27 | Professional | None | $562.34 | $891.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $1,348.96 Typical High $1,862.09 | Professional | 50 · Both sides | $851.14 | $1,348.96 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $11,481.54 Typical High $18,620.87 | Facility | None | $707.95 | $11,481.54 | $18,620.87 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,445.44 | Professional | None | $758.58 | $794.33 | $1,445.44 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,230.27 | Professional | None | $691.83 | $912.01 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $630.96 | Professional | None | $588.84 | $588.84 | $630.96 |
United Setting Facility Modifier None Typical Low $2,137.96 Median $2,691.53 Typical High $7,079.46 | Facility | None | $2,137.96 | $2,691.53 | $7,079.46 |
United Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,288.25 | Professional | None | $645.65 | $977.24 | $1,288.25 |
5 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 $295.12 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $117.49 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | 54 · Surgery only | $436.52 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $58.88 |
Where Maine sits
The same service costs 11.7 times more in Oklahoma than in Utah. 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· 31st of 51
$871
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.