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 Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $102.33 | Facility | None | $38.02 | $39.81 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $61.66 Typical High $165.96 | Professional | None | $38.02 | $61.66 | $165.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $66.07 Typical High $162.18 | Professional | None | $30.90 | $66.07 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $83.18 Typical High $194.98 | Professional | None | $39.81 | $83.18 | $194.98 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $32.36 Median $69.18 Typical High $131.83 | Professional | None | $32.36 | $69.18 | $131.83 |
Martin's Point Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $125.89 | Facility | None | $38.02 | $39.81 | $125.89 |
Martin's Point Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $165.96 | Professional | None | $38.02 | $69.18 | $165.96 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $123.03 | Professional | None | $30.90 | $54.95 | $123.03 |
6 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 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $75.86 | Professional | 54 · Surgery only | $28.84 | $28.84 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $15.14 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $10.00 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $28.84 Typical High $75.86 | Professional | 54 · Surgery only | $28.84 | $28.84 | $75.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $5.75 Typical High $15.14 | Professional | 55 · Aftercare only | $5.75 | $5.75 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $10.00 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $10.00 |
Where Maine sits
The same service costs 2.8 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· 30th of 51
$74.13
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.