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 $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $275.42 | Facility | None | $114.82 | $147.91 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | None | $70.79 | $70.79 | $77.62 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | RR · Rental | $7.08 | $7.08 | $7.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | UE · Used equipment | $52.48 | $52.48 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $75.86 | Professional | None | $54.95 | $54.95 | $75.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $47.86 Median $102.33 Typical High $131.83 | Professional | None | $47.86 | $102.33 | $131.83 |
Martin's Point Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $87.10 | Facility | None | $77.62 | $77.62 | $87.10 |
United Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $162.18 | Professional | None | $45.71 | $57.54 | $162.18 |
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 $34.67 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $34.67 | $35.48 | $35.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $14.13 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.92 | $7.08 | $7.08 |
Where Maine sits
The same service costs 4.4 times more in Kansas than in Vermont. 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· 34th of 51
$70.79
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.