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 $16.98 Median $18.62 Typical High $18.62 | Professional | None | $16.98 | $18.62 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $33.11 | Professional | None | $16.60 | $20.42 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $21.38 Typical High $38.90 | Professional | None | $19.50 | $21.38 | $38.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.20 Median $24.55 Typical High $35.48 | Professional | None | $18.20 | $24.55 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $18.62 | Professional | None | $18.20 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $17.78 Median $25.12 Typical High $34.67 | Professional | None | $17.78 | $25.12 | $34.67 |
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 $8.51 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $8.51 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.39 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.57 | $2.82 | $2.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.70 | $1.86 | $1.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.12 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.63 | $3.72 | $3.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | 55 · Aftercare only | $2.69 | $2.82 | $2.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.82 | $1.86 | $1.86 |
Where Maine sits
The same service costs 3.4 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· 21st of 51
$21.38
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.