How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $70.79 Median $75.86 Typical High $123.03 | Professional | None | $70.79 | $75.86 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $134.90 | Professional | None | $66.07 | $77.62 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $158.49 | Professional | None | $77.62 | $87.10 | $158.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $131.83 | Professional | None | $72.44 | $91.20 | $131.83 |
Martin's Point Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $123.03 | Professional | None | $74.13 | $75.86 | $123.03 |
United Setting Professional Modifier None Typical Low $72.44 Median $102.33 Typical High $141.25 | Professional | None | $72.44 | $102.33 | $141.25 |
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 $33.88 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $33.88 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $13.49 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.23 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.76 | $7.59 | $7.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $37.15 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.79 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $10.96 | $11.48 | $11.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.41 | $7.59 | $7.59 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 25th of 51
$83.18
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.