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 $29.51 Median $30.90 Typical High $30.90 | Professional | None | $29.51 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $30.90 Typical High $30.90 | Professional | None | $22.39 | $30.90 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $89.13 | Facility | None | $34.67 | $34.67 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $43.65 | Professional | None | $30.20 | $30.90 | $43.65 |
Martin's Point Setting Professional Modifier None Typical Low $30.20 Median $30.90 Typical High $30.90 | Professional | None | $30.20 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $44.67 | Professional | None | $30.20 | $30.20 | $44.67 |
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 $14.79 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.89 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.14 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.03 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.57 Typical High $4.57 | Professional | 55 · Aftercare only | $4.47 | $4.57 | $4.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.09 | $3.09 |
Where Maine sits
The same service costs 4.7 times more in Alaska than in Hawaii. 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· 20th of 51
$30.90
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.