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 $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,513.56 | Facility | None | $630.96 | $794.33 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $363.08 | Professional | None | $354.81 | $354.81 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | RR · Rental | $35.48 | $35.48 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | UE · Used equipment | $263.03 | $263.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $467.74 | Facility | None | $380.19 | $380.19 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $724.44 | Professional | None | $245.47 | $549.54 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $346.74 Median $380.19 Typical High $380.19 | Professional | None | $346.74 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Facility | None | $389.05 | $389.05 | $467.74 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $870.96 | Professional | None | $245.47 | $316.23 | $870.96 |
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 $177.83 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $177.83 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $177.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $70.79 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $38.02 |
Where Maine sits
The same service costs 3.7 times more in Hawaii than in Florida. 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
$363
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.