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 $11.48 Median $12.02 Typical High $12.02 | Professional | None | $11.48 | $12.02 | $12.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.49 Median $17.38 Typical High $35.48 | Facility | None | $13.49 | $17.38 | $35.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.88 | Professional | None | $11.48 | $11.48 | $12.88 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $16.22 Typical High $23.99 | Facility | None | $13.80 | $16.22 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.48 Median $13.80 Typical High $20.42 | Professional | None | $11.48 | $13.80 | $20.42 |
Martin's Point Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $12.02 | Professional | None | $11.48 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $23.44 | Professional | None | $13.80 | $13.80 | $23.44 |
8 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 $5.75 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $5.75 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.29 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.74 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.15 | $1.20 | $1.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $6.03 Typical High $6.03 | Professional | 52 · Reduced service | $5.75 | $6.03 | $6.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.40 Typical High $2.40 | Professional | 53 · Discontinued | $2.29 | $2.40 | $2.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.74 | $1.82 | $1.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.15 | $1.20 | $1.20 |
Where Maine sits
The same service costs 1.8 times more in Alaska than in Kentucky. 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· 44th of 51
$11.48
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.