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 $60.26 Median $85.11 Typical High $85.11 | Professional | None | $60.26 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $331.13 | Facility | None | $138.04 | $173.78 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $75.86 Typical High $81.28 | Professional | None | $74.13 | $75.86 | $81.28 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.41 Median $7.41 Typical High $8.13 | Professional | RR · Rental | $7.41 | $7.41 | $8.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $54.95 Median $54.95 Typical High $61.66 | Professional | UE · Used equipment | $54.95 | $54.95 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $102.33 | Facility | None | $77.62 | $77.62 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $77.62 | Professional | None | $56.23 | $56.23 | $77.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $53.70 Median $120.23 Typical High $158.49 | Professional | None | $53.70 | $120.23 | $158.49 |
Martin's Point Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | None | $72.44 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $81.28 | Facility | None | $60.26 | $60.26 | $81.28 |
United Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $190.55 | Professional | None | $53.70 | $69.18 | $190.55 |
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 $36.31 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $8.51 | $8.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $36.31 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $16.98 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.96 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.24 | $8.51 | $8.51 |
Where Maine sits
The same service costs 3.1 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· 32nd of 51
$75.86
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.