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 $87.10 Median $93.33 Typical High $93.33 | Professional | None | $87.10 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $165.96 | Professional | None | $83.18 | $97.72 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $194.98 | Professional | None | $97.72 | $107.15 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $162.18 | Professional | None | $91.20 | $114.82 | $162.18 |
Martin's Point Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | None | $89.13 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $173.78 | Professional | None | $89.13 | $125.89 | $173.78 |
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 $43.65 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $43.65 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.38 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.71 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $46.77 | $46.77 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $18.62 | $18.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $9.33 | $9.33 |
Where Maine sits
The same service costs 3.1 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· 24th of 51
$105
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.