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 $3,388.44 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,388.44 | $3,548.13 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $3,235.94 | Facility | None | $1,548.82 | $1,949.84 | $3,235.94 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,890.45 | Professional | None | $3,467.37 | $3,548.13 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $10,232.93 | Facility | None | $1,445.44 | $1,445.44 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $5,128.61 | Professional | None | $3,467.37 | $3,548.13 | $5,128.61 |
Martin's Point Setting Professional Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,981.07 | Professional | None | $3,467.37 | $3,548.13 | $3,981.07 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $6,165.95 | Professional | None | $3,467.37 | $3,467.37 | $6,165.95 |
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 $1,445.44 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,445.44 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $575.44 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $436.52 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $288.40 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,778.28 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,778.28 | $1,778.28 | $1,778.28 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $707.95 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | 55 · Aftercare only | $537.03 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $354.81 | $354.81 | $354.81 |
Where Maine sits
The same service costs 1.6 times more in North Carolina than in Nebraska. 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· 7th of 51
$3,548
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.