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 $63.10 Median $63.10 Typical High $83.18 | Facility | None | $63.10 | $63.10 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $141.25 | Professional | None | $63.10 | $83.18 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $147.91 | Professional | None | $67.61 | $97.72 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $151.36 | Professional | None | $74.13 | $77.62 | $151.36 |
Community Health Options Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $158.49 | Professional | None | $91.20 | $128.82 | $158.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $141.25 | Professional | None | $79.43 | $102.33 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $117.49 | Professional | None | $63.10 | $83.18 | $117.49 |
United Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $154.88 | Professional | None | $72.44 | $107.15 | $154.88 |
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 $31.62 Median $31.62 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 52 · Reduced service | $31.62 | $31.62 | $35.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $10.47 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $10.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $7.08 |
Where Maine sits
The same service costs 2.4 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· 20th of 51
$85.11
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.