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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $28.84 | Professional | None | $24.55 | $25.70 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $29.51 Typical High $75.86 | Facility | None | $22.91 | $29.51 | $75.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | None | $24.55 | $24.55 | $26.92 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $34.67 Typical High $40.74 | Facility | None | $23.99 | $34.67 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.99 Median $24.55 Typical High $34.67 | Professional | None | $23.99 | $24.55 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $24.55 Median $25.70 Typical High $28.18 | Professional | None | $24.55 | $25.70 | $28.18 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $41.69 | Professional | None | $23.99 | $23.99 | $41.69 |
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 $12.30 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $4.90 | $5.13 | $5.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.72 | $3.80 | $3.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.45 | $2.51 | $2.51 |
Where Maine sits
The same service costs 2.8 times more in Wyoming than in North Carolina. 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· 31st of 51
$24.55
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.