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 $33.88 Median $46.77 Typical High $46.77 | Professional | None | $33.88 | $46.77 | $46.77 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $186.21 | Facility | None | $75.86 | $97.72 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $41.69 Typical High $44.67 | Professional | None | $40.74 | $41.69 | $44.67 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.07 Median $4.07 Typical High $4.47 | Professional | RR · Rental | $4.07 | $4.07 | $4.47 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | UE · Used equipment | $30.20 | $30.20 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Facility | None | $36.31 | $36.31 | $56.23 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $36.31 | Professional | None | $26.92 | $26.92 | $36.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $30.20 Median $67.61 Typical High $89.13 | Professional | None | $30.20 | $67.61 | $89.13 |
Martin's Point Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $46.77 | Professional | None | $40.74 | $46.77 | $46.77 |
United Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
United Setting Professional Modifier None Typical Low $30.20 Median $38.02 Typical High $107.15 | Professional | None | $30.20 | $38.02 | $107.15 |
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 $20.89 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $20.89 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.31 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.17 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $20.89 | $23.44 | $23.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $8.32 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $6.31 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.17 | $4.68 | $4.68 |
Where Maine sits
The same service costs 2.9 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· 26th of 51
$41.69
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.