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 Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $269.15 | Professional | None | $169.82 | $190.55 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $389.05 | Professional | None | $204.17 | $269.15 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $389.05 | Professional | None | $229.09 | $229.09 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $407.38 | Professional | None | $229.09 | $295.12 | $407.38 |
Martin's Point Setting Professional Modifier None Typical Low $169.82 Median $190.55 Typical High $269.15 | Professional | None | $169.82 | $190.55 | $269.15 |
United Setting Professional Modifier None Typical Low $218.78 Median $316.23 Typical High $416.87 | Professional | None | $218.78 | $316.23 | $416.87 |
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 $91.20 Median $95.50 Typical High $100.00 | Professional | 52 · Reduced service | $91.20 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.18 Typical High $29.51 | Professional | 55 · Aftercare only | $27.54 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $19.05 Typical High $19.95 | Professional | 56 · Pre-op care only | $18.62 | $19.05 | $19.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $95.50 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $19.05 |
Where Maine sits
The same service costs 2.4 times more in Alaska than in Utah. 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
$224
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.