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 $173.78 Median $204.17 Typical High $478.63 | Facility | None | $173.78 | $204.17 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $269.15 | Professional | None | $173.78 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $177.83 Typical High $338.84 | Professional | None | $134.90 | $177.83 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $239.88 Typical High $338.84 | Professional | None | $181.97 | $239.88 | $338.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $371.54 | Professional | None | $190.55 | $257.04 | $371.54 |
Martin's Point Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $269.15 | Facility | None | $173.78 | $204.17 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $269.15 | Professional | None | $173.78 | $199.53 | $269.15 |
United Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $363.08 | Professional | None | $186.21 | $239.88 | $363.08 |
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 $87.10 Median $97.72 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $29.51 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $29.51 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.50 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $19.50 | $20.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $100.00 Typical High $102.33 | Professional | 52 · Reduced service | $87.10 | $100.00 | $102.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $30.20 Typical High $30.90 | Professional | 55 · Aftercare only | $26.30 | $30.20 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.95 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $19.95 | $20.42 |
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· 29th of 51
$204
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.