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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | None | $158.49 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $162.18 | Professional | None | $114.82 | $134.90 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $501.19 | Professional | None | $208.93 | $323.59 | $501.19 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $229.09 | Professional | None | $158.49 | $229.09 | $229.09 |
United Setting Professional Modifier None Typical Low $134.90 Median $288.40 Typical High $457.09 | Professional | None | $134.90 | $288.40 | $457.09 |
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 $79.43 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $87.10 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $34.67 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $25.70 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $17.38 | $22.91 | $22.91 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 38th of 51
$178
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.