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 Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $31.62 | Professional | None | $25.12 | $25.70 | $31.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.70 | Professional | None | $25.12 | $25.12 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $70.79 | Facility | None | $34.67 | $34.67 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $25.12 | Professional | None | $16.60 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier None Typical Low $25.12 Median $25.70 Typical High $28.84 | Professional | None | $25.12 | $25.70 | $28.84 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $28.84 | Professional | None | $16.60 | $16.60 | $28.84 |
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 $12.30 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.01 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.45 | $2.57 | $2.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.01 | $5.13 | $5.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.89 | $3.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.45 | $2.57 | $2.57 |
Where Maine sits
The same service costs 1.9 times more in Wyoming than in Arizona. 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· 9th of 51
$25.12
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.