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 $1.32 Median $1.35 Typical High $1.35 | Professional | None | $1.32 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.66 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.66 | $0.68 | $0.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.41 | Professional | None | $1.32 | $1.32 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $1.82 Median $1.82 Typical High $3.72 | Facility | None | $1.82 | $1.82 | $3.72 |
Cigna Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.95 | Professional | None | $1.32 | $1.32 | $1.95 |
Martin's Point Setting Professional Modifier None Typical Low $1.32 Median $1.35 Typical High $1.35 | Professional | None | $1.32 | $1.35 | $1.35 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.66 Median $0.68 Typical High $0.68 | Professional | 52 · Reduced service | $0.66 | $0.68 | $0.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.26 Median $0.27 Typical High $0.27 | Professional | 53 · Discontinued | $0.26 | $0.27 | $0.27 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.14 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $2.34 | Professional | None | $1.32 | $1.32 | $2.34 |
2 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 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.20 |
Where Maine sits
The same service costs 1.9 times more in Wyoming than in Florida. 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· 40th of 51
$1.32
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.