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 $33.88 Median $39.81 Typical High $70.79 | Professional | None | $33.88 | $39.81 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $43.65 Typical High $69.18 | Professional | None | $30.20 | $43.65 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $45.71 Typical High $81.28 | Professional | None | $44.67 | $45.71 | $81.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $37.15 Median $51.29 Typical High $69.18 | Professional | None | $37.15 | $51.29 | $69.18 |
Martin's Point Setting Professional Modifier None Typical Low $34.67 Median $39.81 Typical High $70.79 | Professional | None | $34.67 | $39.81 | $70.79 |
United Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $72.44 | Professional | None | $38.90 | $53.70 | $72.44 |
4 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 $17.78 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $17.78 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $19.05 | $19.95 | $19.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.59 | $7.94 | $7.94 |
Where Maine sits
The same service costs 2.7 times more in Alaska than in New York. 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· 30th of 51
$45.71
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.