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 Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Facility | None | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $60.26 | Professional | None | $33.88 | $35.48 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $27.54 Median $35.48 Typical High $58.88 | Facility | None | $27.54 | $35.48 | $58.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $35.48 | Professional | None | $33.88 | $33.88 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $47.86 Typical High $66.07 | Facility | None | $26.30 | $47.86 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $28.18 Median $33.88 Typical High $41.69 | Professional | None | $28.18 | $33.88 | $41.69 |
Martin's Point Setting Professional Modifier None Typical Low $33.88 Median $35.48 Typical High $60.26 | Professional | None | $33.88 | $35.48 | $60.26 |
United Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $50.12 | Professional | None | $28.18 | $28.18 | $50.12 |
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 $16.98 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $16.98 | $17.78 | $17.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $6.76 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.13 | $5.37 | $5.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.39 | $3.55 | $3.55 |
Where Maine sits
The same service costs 5.4 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
$33.88
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.