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 $27.54 Median $27.54 Typical High $45.71 | Facility | None | $27.54 | $27.54 | $45.71 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $70.79 | Professional | None | $27.54 | $36.31 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $40.74 Typical High $81.28 | Professional | None | $21.38 | $40.74 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $46.77 Typical High $85.11 | Professional | None | $27.54 | $46.77 | $85.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $40.74 Typical High $69.18 | Professional | None | $25.70 | $40.74 | $69.18 |
Martin's Point Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $53.70 | Facility | None | $27.54 | $27.54 | $53.70 |
Martin's Point Setting Professional Modifier None Typical Low $27.54 Median $36.31 Typical High $70.79 | Professional | None | $27.54 | $36.31 | $70.79 |
United Setting Professional Modifier None Typical Low $25.12 Median $40.74 Typical High $69.18 | Professional | None | $25.12 | $40.74 | $69.18 |
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 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $6.92 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.57 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $6.92 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $6.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.75 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.75 | $2.75 | $4.57 |
Where Maine sits
The same service costs 2.5 times more in Alaska 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· 24th of 51
$40.74
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.