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 $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $223.87 Typical High $354.81 | Professional | None | $151.36 | $223.87 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $363.08 | Professional | None | $190.55 | $223.87 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $338.84 | Professional | None | $181.97 | $239.88 | $338.84 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | None | $186.21 | $223.87 | $223.87 |
United Setting Professional Modifier None Typical Low $165.96 Median $239.88 Typical High $331.13 | Professional | None | $165.96 | $239.88 | $331.13 |
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 $91.20 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $91.20 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $36.31 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.20 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $93.33 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $37.15 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $28.18 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $18.62 | $22.39 | $22.39 |
Where Maine sits
The same service costs 2.9 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· 25th of 51
$224
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.