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 $13.80 Median $18.20 Typical High $18.20 | Professional | None | $13.80 | $18.20 | $18.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $29.51 Median $38.02 Typical High $72.44 | Facility | None | $29.51 | $38.02 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $18.62 Typical High $19.95 | Professional | None | $18.20 | $18.62 | $19.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $2.00 | Professional | RR · Rental | $1.82 | $1.82 | $2.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | UE · Used equipment | $13.49 | $13.49 | $14.79 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $22.39 Typical High $22.39 | Facility | None | $20.89 | $22.39 | $22.39 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.30 Median $26.30 Typical High $34.67 | Professional | None | $12.30 | $26.30 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $19.05 | Professional | None | $16.60 | $18.20 | $19.05 |
United Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $28.18 | Facility | None | $19.95 | $19.95 | $28.18 |
United Setting Professional Modifier None Typical Low $11.75 Median $14.79 Typical High $41.69 | Professional | None | $11.75 | $14.79 | $41.69 |
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 $8.91 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $9.12 Typical High $9.12 | Professional | 52 · Reduced service | $8.91 | $9.12 | $9.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 53 · Discontinued | $3.63 | $3.63 | $3.63 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Where Maine sits
The same service costs 3.7 times more in Hawaii than in Florida. 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
$18.20
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.