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 $39.81 Median $56.23 Typical High $56.23 | Professional | None | $39.81 | $56.23 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $141.25 | Facility | None | $58.88 | $75.86 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | None | $53.70 | $53.70 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $5.37 Typical High $5.89 | Professional | RR · Rental | $4.57 | $5.37 | $5.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $40.74 Typical High $43.65 | Professional | UE · Used equipment | $30.20 | $40.74 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $57.54 | Facility | None | $52.48 | $52.48 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $52.48 | Professional | None | $44.67 | $44.67 | $52.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $51.29 Typical High $104.71 | Professional | None | $34.67 | $51.29 | $104.71 |
Martin's Point Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $56.23 | Professional | None | $41.69 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $125.89 | Professional | None | $30.20 | $45.71 | $125.89 |
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 $20.89 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $8.32 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $8.32 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $5.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $20.89 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $11.22 Typical High $11.22 | Professional | 53 · Discontinued | $8.32 | $11.22 | $11.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.32 Typical High $8.32 | Professional | 55 · Aftercare only | $6.31 | $8.32 | $8.32 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.62 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.17 | $5.62 | $5.62 |
Where Maine sits
The same service costs 2.6 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· 17th of 51
$53.70
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.