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 $141.25 Typical High $141.25 | Professional | None | $107.15 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $234.42 Median $295.12 Typical High $562.34 | Facility | None | $234.42 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $107.15 Typical High $109.65 | Professional | None | $89.13 | $107.15 | $109.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $10.72 Typical High $11.75 | Professional | RR · Rental | $10.72 | $10.72 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | UE · Used equipment | $79.43 | $79.43 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $173.78 | Facility | None | $123.03 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $269.15 | Professional | None | $91.20 | $204.17 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $141.25 | Professional | None | $109.65 | $141.25 | $141.25 |
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 $83.18 Median $117.49 Typical High $323.59 | Professional | None | $83.18 | $117.49 | $323.59 |
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 $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $54.95 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $21.88 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $16.22 | $21.38 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $10.96 | $14.13 | $14.13 |
Where Maine sits
The same service costs 2.5 times more in Hawaii than in Arizona. 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
$110
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.