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 $10.47 Median $14.13 Typical High $30.90 | Professional | None | $10.47 | $14.13 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $16.98 Typical High $33.88 | Professional | None | $8.71 | $16.98 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $19.95 | Facility | None | $13.80 | $13.80 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $12.59 Median $21.88 Typical High $34.67 | Professional | None | $12.59 | $21.88 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.48 Median $17.78 Typical High $35.48 | Professional | None | $11.48 | $17.78 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $10.00 Median $14.13 Typical High $30.90 | Professional | None | $10.00 | $14.13 | $30.90 |
United Setting Professional Modifier None Typical Low $12.59 Median $17.78 Typical High $28.18 | Professional | None | $12.59 | $17.78 | $28.18 |
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 $7.08 Median $7.08 Typical High $13.18 | Professional | 52 · Reduced service | $7.08 | $7.08 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $5.25 | Professional | 53 · Discontinued | $2.82 | $2.82 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $3.89 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $2.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.08 Typical High $13.18 | Professional | 52 · Reduced service | $7.08 | $7.08 | $13.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $2.82 Typical High $5.25 | Professional | 53 · Discontinued | $2.82 | $2.82 | $5.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $3.89 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $3.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $2.63 |
Where Maine sits
The same service costs 3.1 times more in Wisconsin than in Louisiana. 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· 42nd of 51
$16.98
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.