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 $23.99 Median $28.84 Typical High $41.69 | Professional | None | $23.99 | $28.84 | $41.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.98 Median $24.55 Typical High $46.77 | Professional | None | $16.98 | $24.55 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $21.38 Median $47.86 Typical High $707.95 | Facility | None | $21.38 | $47.86 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $39.81 Typical High $61.66 | Professional | None | $25.70 | $39.81 | $61.66 |
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 $19.05 Median $31.62 Typical High $60.26 | Professional | None | $19.05 | $31.62 | $60.26 |
Martin's Point Setting Professional Modifier None Typical Low $23.99 Median $36.31 Typical High $41.69 | Professional | None | $23.99 | $36.31 | $41.69 |
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 $19.05 Median $31.62 Typical High $50.12 | Professional | None | $19.05 | $31.62 | $50.12 |
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 $12.02 Median $12.88 Typical High $20.89 | Professional | 52 · Reduced service | $12.02 | $12.88 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.25 Typical High $8.32 | Professional | 53 · Discontinued | $4.79 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.89 Typical High $6.31 | Professional | 55 · Aftercare only | $3.63 | $3.89 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $4.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.02 Median $12.88 Typical High $20.89 | Professional | 52 · Reduced service | $12.02 | $12.88 | $20.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.25 Typical High $8.32 | Professional | 53 · Discontinued | $4.79 | $5.25 | $8.32 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $3.89 Typical High $6.31 | Professional | 55 · Aftercare only | $3.63 | $3.89 | $6.31 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.57 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.40 | $2.57 | $4.17 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 48th of 51
$30.20
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.