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 $64.57 Median $85.11 Typical High $186.21 | Professional | None | $64.57 | $85.11 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $257.04 | Professional | None | $67.61 | $128.82 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $162.18 Typical High $295.12 | Professional | None | $83.18 | $162.18 | $295.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $288.40 | Professional | None | $67.61 | $151.36 | $288.40 |
Martin's Point Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $186.21 | Professional | None | $69.18 | $85.11 | $186.21 |
United Setting Professional Modifier None Typical Low $75.86 Median $147.91 Typical High $257.04 | Professional | None | $75.86 | $147.91 | $257.04 |
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 $34.67 Median $36.31 Typical High $77.62 | Professional | 52 · Reduced service | $34.67 | $36.31 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $14.45 Typical High $30.90 | Professional | 53 · Discontinued | $13.80 | $14.45 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $117.49 | Professional | 54 · Surgery only | $52.48 | $53.70 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $23.44 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $15.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $36.31 Typical High $77.62 | Professional | 52 · Reduced service | $34.67 | $36.31 | $77.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $30.90 | Professional | 53 · Discontinued | $14.13 | $14.45 | $30.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $53.70 Typical High $117.49 | Professional | 54 · Surgery only | $52.48 | $53.70 | $117.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.72 Typical High $23.44 | Professional | 55 · Aftercare only | $10.47 | $10.72 | $23.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.24 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.92 | $7.24 | $15.49 |
Where Maine sits
The same service costs 3.5 times more in Alaska 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· 26th of 51
$141
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.