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 $20.89 Median $20.89 Typical High $107.15 | Facility | None | $20.89 | $20.89 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $20.89 Typical High $107.15 | Professional | None | $16.22 | $20.89 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.14 Median $21.38 Typical High $57.54 | Professional | None | $15.14 | $21.38 | $57.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $22.91 Median $33.11 Typical High $95.50 | Professional | 50 · Both sides | $22.91 | $33.11 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $102.33 Typical High $707.95 | Facility | None | $56.23 | $102.33 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $83.18 Typical High $120.23 | Professional | None | $22.39 | $83.18 | $120.23 |
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 $16.60 Median $56.23 Typical High $141.25 | Professional | None | $16.60 | $56.23 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $107.15 | Professional | None | $16.60 | $20.89 | $107.15 |
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 $16.60 Median $53.70 Typical High $114.82 | Professional | None | $16.60 | $53.70 | $114.82 |
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 $10.47 Median $10.47 Typical High $53.70 | Professional | 52 · Reduced service | $10.47 | $10.47 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $21.38 | Professional | 53 · Discontinued | $4.17 | $4.17 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $16.22 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $10.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $53.70 | Professional | 52 · Reduced service | $10.47 | $10.47 | $53.70 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.17 Typical High $21.38 | Professional | 53 · Discontinued | $4.17 | $4.17 | $21.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $16.22 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $16.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $10.72 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $10.72 |
Where Maine sits
The same service costs 5.9 times more in Iowa 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· 48th of 51
$26.30
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.