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 $11.75 Median $15.85 Typical High $15.85 | Professional | None | $11.75 | $15.85 | $15.85 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $33.11 Typical High $63.10 | Facility | None | $25.70 | $33.11 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | None | $11.48 | $11.48 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.15 Median $1.15 Typical High $1.26 | Professional | RR · Rental | $1.15 | $1.15 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | UE · Used equipment | $8.71 | $8.71 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $19.50 | Facility | None | $13.49 | $13.49 | $19.50 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.23 Median $22.91 Typical High $30.20 | Professional | None | $10.23 | $22.91 | $30.20 |
Martin's Point Setting Professional Modifier None Typical Low $11.75 Median $15.85 Typical High $15.85 | Professional | None | $11.75 | $15.85 | $15.85 |
United Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Facility | None | $7.94 | $7.94 | $9.77 |
United Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $36.31 | Professional | None | $9.77 | $13.18 | $36.31 |
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 $6.03 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $6.03 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $2.45 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $1.82 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.23 | $1.58 | $1.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $6.03 Median $7.94 Typical High $7.94 | Professional | 52 · Reduced service | $6.03 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $3.16 Typical High $3.16 | Professional | 53 · Discontinued | $2.45 | $3.16 | $3.16 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $1.82 | $2.40 | $2.40 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.58 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.23 | $1.58 | $1.58 |
Where Maine sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 33rd of 51
$12.59
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.