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 $436.52 Median $457.09 Typical High $467.74 | Professional | None | $436.52 | $457.09 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $933.25 | Professional | None | $436.52 | $588.84 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $1,047.13 | Professional | None | $501.19 | $602.56 | $1,047.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,000.00 | Professional | None | $446.68 | $645.65 | $1,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $467.74 | Professional | None | $457.09 | $457.09 | $467.74 |
United Setting Professional Modifier None Typical Low $426.58 Median $616.60 Typical High $977.24 | Professional | None | $426.58 | $616.60 | $977.24 |
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 $218.78 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $218.78 | $229.09 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $87.10 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $43.65 | $45.71 | $46.77 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $234.42 | Professional | 52 · Reduced service | $229.09 | $229.09 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $91.20 Typical High $93.33 | Professional | 53 · Discontinued | $91.20 | $91.20 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $46.77 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $46.77 |
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· 18th of 51
$603
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.