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 $8.71 Median $9.12 Typical High $9.12 | Professional | None | $8.71 | $9.12 | $9.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.32 Median $10.72 Typical High $17.78 | Facility | None | $8.32 | $10.72 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | None | $8.71 | $8.71 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $7.24 Median $11.22 Typical High $12.30 | Facility | None | $7.24 | $11.22 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $12.59 | Professional | None | $8.71 | $8.71 | $12.59 |
Martin's Point Setting Professional Modifier None Typical Low $8.71 Median $9.12 Typical High $9.12 | Professional | None | $8.71 | $9.12 | $9.12 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $12.88 | Professional | None | $8.71 | $8.71 | $12.88 |
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 $4.37 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $4.37 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.74 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.89 | $0.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 52 · Reduced service | $4.37 | $4.47 | $4.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.74 Median $1.82 Typical High $1.82 | Professional | 53 · Discontinued | $1.74 | $1.82 | $1.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.29 | $1.35 | $1.35 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.87 Median $0.89 Typical High $0.89 | Professional | 56 · Pre-op care only | $0.87 | $0.89 | $0.89 |
Where Maine sits
The same service costs 1.9 times more in Wyoming than in Mississippi. 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· 34th of 51
$8.71
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.