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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $66.07 | Professional | None | $60.26 | $63.10 | $66.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $177.83 | Facility | None | $54.95 | $69.18 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $85.11 | Facility | None | $48.98 | $51.29 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $56.23 Median $60.26 Typical High $81.28 | Professional | None | $56.23 | $60.26 | $81.28 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $63.10 Typical High $66.07 | Professional | None | $60.26 | $63.10 | $66.07 |
United Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $91.20 | Professional | None | $56.23 | $56.23 | $91.20 |
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 $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $30.20 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.12 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $6.03 | $6.31 | $6.31 |
Where Maine sits
The same service costs 2.0 times more in Wyoming than in Hawaii. 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· 28th of 51
$60.26
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.