How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $645.65 Median $676.08 Typical High $776.25 | Professional | None | $645.65 | $676.08 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,445.44 | Professional | None | $676.08 | $912.01 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $1,584.89 | Professional | None | $758.58 | $933.25 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $977.24 Typical High $1,548.82 | Professional | None | $645.65 | $977.24 | $1,548.82 |
Martin's Point Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $794.33 | Professional | None | $676.08 | $676.08 | $794.33 |
United Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,412.54 | Professional | None | $630.96 | $912.01 | $1,412.54 |
8 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 $323.59 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $323.59 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $128.82 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $97.72 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $64.57 | $67.61 | $70.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $338.84 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $338.84 | $338.84 | $354.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $134.90 Typical High $144.54 | Professional | 53 · Discontinued | $134.90 | $134.90 | $144.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $107.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $107.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $67.61 | $67.61 | $70.79 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in New York. 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· 20th of 51
$912
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.