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 $112.20 Median $144.54 Typical High $346.74 | Facility | None | $112.20 | $144.54 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $208.93 | Professional | None | $112.20 | $144.54 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $181.97 Typical High $263.03 | Professional | None | $131.83 | $181.97 | $263.03 |
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 $128.82 Median $162.18 Typical High $275.42 | Professional | None | $128.82 | $162.18 | $275.42 |
Community Health Options Setting Professional Modifier None Typical Low $194.98 Median $251.19 Typical High $338.84 | Professional | None | $194.98 | $251.19 | $338.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $281.84 | Professional | None | $128.82 | $181.97 | $281.84 |
Martin's Point Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $223.87 | Facility | None | $112.20 | $144.54 | $223.87 |
Martin's Point Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $218.78 | Professional | None | $112.20 | $144.54 | $218.78 |
United Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $263.03 | Professional | None | $125.89 | $169.82 | $263.03 |
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 $56.23 Median $64.57 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.50 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $12.88 | $14.45 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $66.07 | $70.79 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.95 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $19.95 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $11.22 | $13.18 | $14.45 |
Where Maine sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 23rd of 51
$155
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.