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 $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $1,621.81 | Facility | None | $660.69 | $851.14 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $371.54 | Professional | None | $338.84 | $338.84 | $371.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | RR · Rental | $33.88 | $33.88 | $37.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $257.04 Median $257.04 Typical High $281.84 | Professional | UE · Used equipment | $257.04 | $257.04 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $501.19 | Facility | None | $416.87 | $416.87 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $416.87 | Professional | None | $309.03 | $309.03 | $416.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $776.25 | Professional | None | $263.03 | $588.84 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $371.54 | Facility | None | $363.08 | $363.08 | $371.54 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $933.25 | Professional | None | $263.03 | $338.84 | $933.25 |
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 $165.96 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $40.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $50.12 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $40.74 | $40.74 |
Where Maine sits
The same service costs 2.9 times more in Hawaii than in Washington, DC. 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· 33rd of 51
$339
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.