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 Professional Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,981.07 | $4,073.80 | $4,073.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.03 Median $0.03 Typical High $0.03 | Facility | None | $0.03 | $0.03 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,073.80 Median $4,786.30 Typical High $5,623.41 | Professional | None | $4,073.80 | $4,786.30 | $5,623.41 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $13,803.84 | Facility | None | $4,786.30 | $4,786.30 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,786.30 | $4,786.30 | $4,786.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,786.30 Median $5,623.41 Typical High $8,317.64 | Professional | None | $4,786.30 | $5,623.41 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $3,981.07 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,981.07 | $4,073.80 | $4,073.80 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $8,511.38 | Professional | None | $5,623.41 | $5,623.41 | $8,511.38 |
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 $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,995.26 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $794.33 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $588.84 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $588.84 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $398.11 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,995.26 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,995.26 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $794.33 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $794.33 | $812.83 | $812.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $602.56 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $602.56 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $398.11 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $398.11 | $407.38 | $407.38 |
Where Maine sits
The same service costs 1.5 times more in Alaska than in Idaho. 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
$4,786
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.