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 $24.55 Median $30.90 Typical High $57.54 | Professional | None | $24.55 | $30.90 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $69.18 Typical High $128.82 | Facility | None | $53.70 | $69.18 | $128.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | None | $30.90 | $30.90 | $33.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.09 Median $3.09 Typical High $3.39 | Professional | RR · Rental | $3.09 | $3.09 | $3.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $22.91 Median $22.91 Typical High $25.12 | Professional | UE · Used equipment | $22.91 | $22.91 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | None | $25.70 | $25.70 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.89 Median $47.86 Typical High $63.10 | Professional | None | $20.89 | $47.86 | $63.10 |
Martin's Point Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $57.54 | Professional | None | $23.44 | $30.90 | $57.54 |
United Setting Professional Modifier None Typical Low $20.89 Median $26.92 Typical High $75.86 | Professional | None | $20.89 | $26.92 | $75.86 |
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 $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $15.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $6.17 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where Maine sits
The same service costs 2.2 times more in Hawaii than in Utah. 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· 41st of 51
$30.90
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.