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 $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $616.60 | Facility | None | $251.19 | $323.59 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $134.90 | Professional | None | $123.03 | $123.03 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | RR · Rental | $12.30 | $12.30 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $91.20 Median $91.20 Typical High $102.33 | Professional | UE · Used equipment | $91.20 | $91.20 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $186.21 | Facility | None | $134.90 | $134.90 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $288.40 | Professional | None | $100.00 | $223.87 | $288.40 |
Martin's Point Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $128.82 | Facility | None | $63.10 | $63.10 | $128.82 |
United Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $354.81 | Professional | None | $95.50 | $125.89 | $354.81 |
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 $60.26 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 52 · Reduced service | $60.26 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 53 · Discontinued | $23.99 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 56 · Pre-op care only | $12.02 | $15.49 | $15.49 |
Where Maine sits
The same service costs 3.9 times more in Kansas than in New Jersey. 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· 30th of 51
$126
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.