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 $22.39 Median $39.81 Typical High $89.13 | Facility | None | $22.39 | $39.81 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $63.10 | Professional | None | $22.39 | $39.81 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $51.29 Typical High $81.28 | Professional | None | $32.36 | $51.29 | $81.28 |
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 $36.31 Median $48.98 Typical High $77.62 | Professional | None | $36.31 | $48.98 | $77.62 |
Community Health Options Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Community Health Options Setting Professional Modifier None Typical Low $66.07 Median $85.11 Typical High $114.82 | Professional | None | $66.07 | $85.11 | $114.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $48.98 Typical High $89.13 | Professional | None | $25.70 | $48.98 | $89.13 |
Martin's Point Setting Facility Modifier None Typical Low $22.39 Median $39.81 Typical High $74.13 | Facility | None | $22.39 | $39.81 | $74.13 |
Martin's Point Setting Professional Modifier None Typical Low $22.39 Median $39.81 Typical High $61.66 | Professional | None | $22.39 | $39.81 | $61.66 |
United Setting Professional Modifier None Typical Low $25.12 Median $42.66 Typical High $70.79 | Professional | None | $25.12 | $42.66 | $70.79 |
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 $11.22 Median $16.22 Typical High $19.95 | Professional | 52 · Reduced service | $11.22 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.79 Typical High $6.03 | Professional | 55 · Aftercare only | $3.39 | $4.79 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.24 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.24 | $3.24 | $3.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $16.60 Typical High $19.95 | Professional | 52 · Reduced service | $11.22 | $16.60 | $19.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.90 Typical High $6.03 | Professional | 55 · Aftercare only | $3.39 | $4.90 | $6.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.39 Typical High $3.98 | Professional | 56 · Pre-op care only | $2.24 | $3.39 | $3.98 |
Where Maine sits
The same service costs 2.4 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· 29th of 51
$42.66
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.