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 $107.15 Median $117.49 Typical High $117.49 | Professional | None | $107.15 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $457.09 | Facility | None | $190.55 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | None | $112.20 | $112.20 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.22 Median $11.22 Typical High $12.30 | Professional | RR · Rental | $11.22 | $11.22 | $12.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | UE · Used equipment | $83.18 | $83.18 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Facility | None | $125.89 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $125.89 | Professional | None | $91.20 | $91.20 | $125.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $165.96 Typical High $218.78 | Professional | None | $75.86 | $165.96 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | None | $109.65 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Facility | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $263.03 | Professional | None | $74.13 | $95.50 | $263.03 |
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 $54.95 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $54.95 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $21.88 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $54.95 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $21.88 | $23.44 | $23.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $10.96 | $11.75 | $11.75 |
Where Maine sits
The same service costs 2.4 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· 39th of 51
$112
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.