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 $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | None | $954.99 | $1,000.00 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $3,981.07 | Facility | None | $1,621.81 | $2,089.30 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | RR · Rental | $91.20 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | UE · Used equipment | $691.83 | $691.83 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Facility | None | $933.25 | $933.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $933.25 | Professional | None | $691.83 | $691.83 | $933.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $645.65 Median $1,445.44 Typical High $1,905.46 | Professional | None | $645.65 | $1,445.44 | $1,905.46 |
Martin's Point Setting Professional Modifier None Typical Low $954.99 Median $1,000.00 Typical High $1,000.00 | Professional | None | $954.99 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $645.65 Median $812.83 Typical High $2,290.87 | Professional | None | $645.65 | $812.83 | $2,290.87 |
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 $478.63 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $478.63 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $478.63 Median $501.19 Typical High $501.19 | Professional | 52 · Reduced service | $478.63 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $199.53 Typical High $199.53 | Professional | 53 · Discontinued | $190.55 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $144.54 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $100.00 Typical High $100.00 | Professional | 56 · Pre-op care only | $95.50 | $100.00 | $100.00 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in Delaware. 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· 34th of 51
$912
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.