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 $70.79 Median $72.44 Typical High $74.13 | Professional | None | $70.79 | $72.44 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $151.36 | Facility | None | $70.79 | $91.20 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Professional | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $100.00 Typical High $109.65 | Facility | None | $74.13 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $107.15 | Professional | None | $70.79 | $74.13 | $107.15 |
Martin's Point Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $74.13 | Professional | None | $70.79 | $72.44 | $74.13 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $109.65 | Professional | None | $74.13 | $74.13 | $109.65 |
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 $35.48 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $7.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $35.48 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $10.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $7.24 |
Where Maine sits
The same service costs 1.5 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· 46th of 51
$70.79
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.