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 $26.30 Median $26.30 Typical High $354.81 | Facility | None | $26.30 | $26.30 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $26.30 Median $208.93 Typical High $354.81 | Professional | None | $26.30 | $208.93 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $21.38 Median $46.77 Typical High $549.54 | Professional | None | $21.38 | $46.77 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $67.61 Typical High $758.58 | Professional | None | $29.51 | $67.61 | $758.58 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.91 Median $64.57 Typical High $562.34 | Professional | None | $22.91 | $64.57 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $26.30 Median $208.93 Typical High $354.81 | Professional | None | $26.30 | $208.93 | $354.81 |
United Setting Professional Modifier None Typical Low $22.39 Median $63.10 Typical High $323.59 | Professional | None | $22.39 | $63.10 | $323.59 |
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 $12.88 Median $104.71 Typical High $177.83 | Professional | 52 · Reduced service | $12.88 | $104.71 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $41.69 Typical High $70.79 | Professional | 53 · Discontinued | $5.25 | $41.69 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $31.62 Typical High $52.48 | Professional | 55 · Aftercare only | $3.89 | $31.62 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $20.89 Typical High $35.48 | Professional | 56 · Pre-op care only | $2.57 | $20.89 | $35.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $13.18 Typical High $177.83 | Professional | 52 · Reduced service | $12.88 | $13.18 | $177.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $70.79 | Professional | 53 · Discontinued | $5.25 | $5.25 | $70.79 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $52.48 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $52.48 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.63 Typical High $35.48 | Professional | 56 · Pre-op care only | $2.57 | $2.63 | $35.48 |
Where Maine sits
The same service costs 16.2 times more in Hawaii 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· 39th of 51
$63.10
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.