How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $18.20 Median $38.02 Typical High $38.02 | Professional | None | $18.20 | $38.02 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | None | $41.69 | $41.69 | $45.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.17 Median $4.17 Typical High $4.57 | Professional | RR · Rental | $4.17 | $4.17 | $4.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | UE · Used equipment | $31.62 | $31.62 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $39.81 Typical High $42.66 | Facility | None | $38.02 | $39.81 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | None | $33.88 | $33.88 | $39.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $25.70 Median $57.54 Typical High $75.86 | Professional | None | $25.70 | $57.54 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $18.20 Median $38.02 Typical High $38.02 | Professional | None | $18.20 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $25.70 Median $33.11 Typical High $91.20 | Professional | None | $25.70 | $33.11 | $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 $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.05 Median $19.05 Typical High $19.05 | Professional | 52 · Reduced service | $19.05 | $19.05 | $19.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Where Maine sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 35th of 51
$41.69
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.