How much rates vary
Facilitymedian $3,388 · 10th to 90th $1,905 to $6,607Professionalmedian $1,479 · 10th to 90th $1,122 to $2,399
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 $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,691.53 Median $3,467.37 Typical High $6,606.93 | Facility | None | $2,691.53 | $3,467.37 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | None | $1,479.11 | $1,479.11 | $1,621.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $147.91 Median $147.91 Typical High $162.18 | Professional | RR · Rental | $147.91 | $147.91 | $162.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | UE · Used equipment | $1,122.02 | $1,122.02 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $1,995.26 | Facility | None | $1,548.82 | $1,548.82 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,122.02 | $1,122.02 | $1,548.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,071.52 Median $2,398.83 Typical High $3,162.28 | Professional | None | $1,071.52 | $2,398.83 | $3,162.28 |
Martin's Point Setting Professional Modifier None Typical Low $1,412.54 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,412.54 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,659.59 | Facility | None | $1,584.89 | $1,584.89 | $1,659.59 |
United Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $3,801.89 | Professional | None | $1,071.52 | $1,348.96 | $3,801.89 |
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 $741.31 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $295.12 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $741.31 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $741.31 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $295.12 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $295.12 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $223.87 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $147.91 | $165.96 | $165.96 |
Where Maine sits
The same service costs 3.1 times more in Hawaii than in Delaware. 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· 28th of 51
$1,514
HI $3,467DE $1,122
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.