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 $69.18 Median $125.89 Typical High $245.47 | Professional | None | $69.18 | $125.89 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $169.82 Typical High $323.59 | Professional | None | $67.61 | $169.82 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $181.97 Typical High $389.05 | Professional | None | $83.18 | $181.97 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $67.61 Median $190.55 Typical High $380.19 | Professional | None | $67.61 | $190.55 | $380.19 |
Martin's Point Setting Professional Modifier None Typical Low $70.79 Median $125.89 Typical High $245.47 | Professional | None | $70.79 | $125.89 | $245.47 |
United Setting Professional Modifier None Typical Low $77.62 Median $173.78 Typical High $331.13 | Professional | None | $77.62 | $173.78 | $331.13 |
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 $35.48 Median $37.15 Typical High $104.71 | Professional | 52 · Reduced service | $35.48 | $37.15 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $41.69 | Professional | 53 · Discontinued | $14.13 | $14.79 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $54.95 Typical High $158.49 | Professional | 54 · Surgery only | $52.48 | $54.95 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $31.62 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $20.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $37.15 Typical High $104.71 | Professional | 52 · Reduced service | $35.48 | $37.15 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.79 Typical High $41.69 | Professional | 53 · Discontinued | $14.45 | $14.79 | $41.69 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $54.95 Typical High $158.49 | Professional | 54 · Surgery only | $53.70 | $54.95 | $158.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.96 Typical High $31.62 | Professional | 55 · Aftercare only | $10.72 | $10.96 | $31.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $20.89 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $20.89 |
Where Maine sits
The same service costs 2.9 times more in Washington 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· 31st of 51
$166
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.