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 Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $44.67 | Facility | None | $13.49 | $13.49 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $19.95 Typical High $60.26 | Professional | None | $12.88 | $19.95 | $60.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.23 Median $28.18 Typical High $60.26 | Professional | None | $10.23 | $28.18 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $44.67 Typical High $81.28 | Professional | None | $16.98 | $44.67 | $81.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.30 Median $37.15 Typical High $69.18 | Professional | None | $12.30 | $37.15 | $69.18 |
Martin's Point Setting Professional Modifier None Typical Low $13.18 Median $21.88 Typical High $60.26 | Professional | None | $13.18 | $21.88 | $60.26 |
United Setting Professional Modifier None Typical Low $12.30 Median $34.67 Typical High $66.07 | Professional | None | $12.30 | $34.67 | $66.07 |
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 $6.31 Median $7.59 Typical High $22.39 | Professional | 52 · Reduced service | $6.31 | $7.59 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $3.02 Typical High $8.91 | Professional | 53 · Discontinued | $2.51 | $3.02 | $8.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.61 Median $7.08 Typical High $22.39 | Professional | 52 · Reduced service | $6.61 | $7.08 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.82 Typical High $8.91 | Professional | 53 · Discontinued | $2.69 | $2.82 | $8.91 |
Where Maine sits
The same service costs 2.5 times more in Kansas than in Maryland. 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
$29.51
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.