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 $21.88 Median $22.39 Typical High $22.39 | Professional | None | $21.88 | $22.39 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $28.84 Typical High $67.61 | Facility | None | $22.39 | $28.84 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $25.70 | Professional | None | $18.62 | $21.88 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $31.62 Typical High $33.11 | Facility | None | $23.44 | $31.62 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $21.88 Median $23.44 Typical High $32.36 | Professional | None | $21.88 | $23.44 | $32.36 |
Martin's Point Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $33.11 | Professional | None | $21.88 | $21.88 | $33.11 |
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 $10.96 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $10.96 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.37 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.24 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.24 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.19 | $2.24 | $2.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 52 · Reduced service | $11.22 | $11.22 | $11.22 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 53 · Discontinued | $4.47 | $4.47 | $4.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.24 |
Where Maine sits
The same service costs 1.5 times more in Alaska 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· 35th of 51
$22.39
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.