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 $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,778.28 Typical High $1,862.09 | Professional | None | $1,318.26 | $1,778.28 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $5,370.32 | Facility | None | $2,089.30 | $2,089.30 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,754.23 | Professional | None | $1,862.09 | $1,862.09 | $2,754.23 |
Martin's Point Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,862.09 | $1,862.09 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,187.76 Typical High $3,162.28 | Professional | None | $1,995.26 | $2,187.76 | $3,162.28 |
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 $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 52 · Reduced service | $933.25 | $933.25 | $933.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | 53 · Discontinued | $371.54 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,412.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $186.21 |
Where Maine sits
The same service costs 537.0 times more in Alaska than in Ohio. 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· 36th of 51
$1,862
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.