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 $36.31 Median $47.86 Typical High $54.95 | Professional | None | $36.31 | $47.86 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $50.12 Typical High $70.79 | Professional | None | $35.48 | $50.12 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $75.86 | Professional | None | $52.48 | $58.88 | $75.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $85.11 | Professional | None | $38.90 | $60.26 | $85.11 |
Martin's Point Setting Professional Modifier None Typical Low $36.31 Median $47.86 Typical High $54.95 | Professional | None | $36.31 | $47.86 | $54.95 |
United Setting Professional Modifier None Typical Low $54.95 Median $74.13 Typical High $89.13 | Professional | None | $54.95 | $74.13 | $89.13 |
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 $17.78 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $17.78 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.37 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $4.79 | $4.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $23.99 Typical High $23.99 | Professional | 52 · Reduced service | $17.78 | $23.99 | $23.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $5.37 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.79 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $4.79 | $4.79 |
Where Maine sits
The same service costs 2.6 times more in Nebraska than in Texas. 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
$53.70
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.