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 $208.93 Median $295.12 Typical High $295.12 | Professional | None | $208.93 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $309.03 Median $398.11 Typical High $758.58 | Facility | None | $309.03 | $398.11 | $758.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | None | $281.84 | $281.84 | $309.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $23.99 Median $28.18 Typical High $30.90 | Professional | RR · Rental | $23.99 | $28.18 | $30.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $213.80 Typical High $229.09 | Professional | UE · Used equipment | $158.49 | $213.80 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $331.13 | Facility | None | $302.00 | $302.00 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $302.00 | Professional | None | $218.78 | $218.78 | $302.00 |
Cigna Setting Professional Modifier RR · Rental Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | RR · Rental | $25.70 | $25.70 | $30.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $549.54 | Professional | None | $181.97 | $269.15 | $549.54 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $295.12 Typical High $295.12 | Professional | None | $218.78 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $162.18 Median $239.88 Typical High $676.08 | Professional | None | $162.18 | $239.88 | $676.08 |
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 $109.65 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $109.65 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $43.65 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $29.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $109.65 Median $147.91 Typical High $147.91 | Professional | 52 · Reduced service | $109.65 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $58.88 Typical High $58.88 | Professional | 53 · Discontinued | $43.65 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $33.11 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $29.51 Typical High $29.51 | Professional | 56 · Pre-op care only | $21.88 | $29.51 | $29.51 |
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· 19th of 51
$282
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.