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 $83.18 Median $91.20 Typical High $91.20 | Professional | None | $83.18 | $91.20 | $91.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $363.08 | Facility | None | $147.91 | $190.55 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $93.33 | Professional | None | $83.18 | $83.18 | $93.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.32 Median $8.32 Typical High $9.33 | Professional | RR · Rental | $8.32 | $8.32 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | UE · Used equipment | $63.10 | $63.10 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $109.65 | Facility | None | $87.10 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $87.10 | Professional | None | $63.10 | $63.10 | $87.10 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $173.78 | Professional | None | $58.88 | $131.83 | $173.78 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | None | $83.18 | $91.20 | $91.20 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $58.88 Median $74.13 Typical High $208.93 | Professional | None | $58.88 | $74.13 | $208.93 |
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 $42.66 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $9.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $45.71 Typical High $45.71 | Professional | 52 · Reduced service | $42.66 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 53 · Discontinued | $16.98 | $18.20 | $18.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 55 · Aftercare only | $12.88 | $13.49 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $9.12 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $9.12 |
Where Maine sits
The same service costs 2.5 times more in Arkansas 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· 33rd of 51
$85.11
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.