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 $275.42 Median $380.19 Typical High $380.19 | Professional | None | $275.42 | $380.19 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $371.54 Median $478.63 Typical High $912.01 | Facility | None | $371.54 | $478.63 | $912.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $331.13 Typical High $354.81 | Professional | None | $245.47 | $331.13 | $354.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $27.54 Median $33.11 Typical High $36.31 | Professional | RR · Rental | $27.54 | $33.11 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $245.47 Typical High $263.03 | Professional | UE · Used equipment | $186.21 | $245.47 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $407.38 | Facility | None | $380.19 | $380.19 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $380.19 | Professional | None | $281.84 | $281.84 | $380.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $724.44 | Professional | None | $213.80 | $331.13 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $380.19 | Professional | None | $275.42 | $380.19 | $380.19 |
United Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $870.96 | Professional | None | $204.17 | $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 $138.04 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $138.04 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $54.95 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $40.74 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $27.54 | $38.02 | $38.02 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in Utah. 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· 21st of 51
$331
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.