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 $20.89 Median $21.88 Typical High $21.88 | Professional | None | $20.89 | $21.88 | $21.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $37.15 Typical High $64.57 | Facility | None | $28.84 | $37.15 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | None | $20.89 | $20.89 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $29.51 Typical High $37.15 | Facility | None | $27.54 | $29.51 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.89 Median $25.12 Typical High $43.65 | Professional | None | $20.89 | $25.12 | $43.65 |
Martin's Point Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | None | $20.89 | $21.88 | $21.88 |
United Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $52.48 | Professional | None | $29.51 | $29.51 | $52.48 |
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 $10.47 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.16 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.19 | $2.19 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 52 · Reduced service | $10.47 | $10.96 | $10.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 53 · Discontinued | $4.17 | $4.37 | $4.37 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.24 Typical High $3.24 | Professional | 55 · Aftercare only | $3.16 | $3.24 | $3.24 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.19 Typical High $2.19 | Professional | 56 · Pre-op care only | $2.09 | $2.19 | $2.19 |
Where Maine sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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· 33rd of 51
$21.88
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.