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 Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $173.78 | Facility | None | $43.65 | $66.07 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $85.11 | Professional | None | $43.65 | $66.07 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $112.20 | Professional | None | $45.71 | $72.44 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $104.71 | Professional | None | $48.98 | $70.79 | $104.71 |
Community Health Options Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None | $104.71 | $104.71 | $104.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $120.23 | Professional | None | $50.12 | $77.62 | $120.23 |
Martin's Point Setting Facility Modifier None Typical Low $43.65 Median $66.07 Typical High $93.33 | Facility | None | $43.65 | $66.07 | $93.33 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $85.11 | Professional | None | $43.65 | $66.07 | $85.11 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $114.82 | Professional | None | $48.98 | $74.13 | $114.82 |
6 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 $21.88 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $21.88 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $6.61 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.37 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.37 | $5.37 | $6.61 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $21.88 Median $26.92 Typical High $33.11 | Professional | 52 · Reduced service | $21.88 | $26.92 | $33.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.13 Typical High $10.00 | Professional | 55 · Aftercare only | $6.61 | $8.13 | $10.00 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.37 Typical High $6.61 | Professional | 56 · Pre-op care only | $4.37 | $5.37 | $6.61 |
Where Maine sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$66.07
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.