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 $245.47 Median $338.84 Typical High $338.84 | Professional | None | $245.47 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $1,348.96 | Facility | None | $549.54 | $707.95 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $281.84 | Professional | None | $251.19 | $263.03 | $281.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $28.18 | Professional | RR · Rental | $25.12 | $25.12 | $28.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $190.55 Median $190.55 Typical High $208.93 | Professional | UE · Used equipment | $190.55 | $190.55 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $407.38 | Facility | None | $316.23 | $316.23 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $316.23 | Professional | None | $229.09 | $229.09 | $316.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $218.78 Median $489.78 Typical High $645.65 | Professional | None | $218.78 | $489.78 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $251.19 Median $338.84 Typical High $338.84 | Professional | None | $251.19 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $269.15 | Facility | None | $245.47 | $245.47 | $269.15 |
United Setting Professional Modifier None Typical Low $199.53 Median $275.42 Typical High $776.25 | Professional | None | $199.53 | $275.42 | $776.25 |
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 $125.89 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $125.89 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $50.12 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $50.12 | $50.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $25.12 | $33.88 | $33.88 |
Where Maine sits
The same service costs 2.6 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· 32nd of 51
$263
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.