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 $5.13 Median $5.13 Typical High $6.76 | Facility | None | $5.13 | $5.13 | $6.76 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $1.02 | $1.02 | $1.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $5.25 | Professional | None | $3.72 | $3.72 | $5.25 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $6.03 | Professional | None | $3.02 | $3.98 | $6.03 |
Community Health Options Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $9.55 | Professional | None | $7.08 | $7.59 | $9.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.68 Median $4.68 Typical High $6.17 | Professional | None | $4.68 | $4.68 | $6.17 |
Martin's Point Setting Facility Modifier None Typical Low $5.13 Median $5.25 Typical High $691.83 | Facility | None | $5.13 | $5.25 | $691.83 |
Martin's Point Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.25 | Professional | None | $5.13 | $5.13 | $5.25 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 52 · Reduced service | $2.51 | $2.51 | $2.51 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | 53 · Discontinued | $1.02 | $1.02 | $1.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.51 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.51 |
United Setting Professional Modifier None Typical Low $4.17 Median $7.24 Typical High $9.55 | Professional | None | $4.17 | $7.24 | $9.55 |
1 more rate 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier HO · Master's level Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | HO · Master's level | $4.68 | $4.68 | $4.68 |
Where Maine sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 27th of 51
$5.13
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.