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 $60.26 Median $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $269.15 | Facility | None | $109.65 | $141.25 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | None | $56.23 | $66.07 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $7.08 | Professional | RR · Rental | $6.46 | $6.46 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | UE · Used equipment | $47.86 | $47.86 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $83.18 | Facility | None | $75.86 | $75.86 | $83.18 |
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 $44.67 Median $97.72 Typical High $128.82 | Professional | None | $44.67 | $97.72 | $128.82 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $67.61 | Professional | None | $60.26 | $67.61 | $67.61 |
United Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $72.44 | Facility | None | $69.18 | $69.18 | $72.44 |
United Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $154.88 | Professional | None | $43.65 | $56.23 | $154.88 |
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 $32.36 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $33.88 Typical High $33.88 | Professional | 52 · Reduced service | $32.36 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $13.49 | $13.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $6.76 |
Where Maine sits
The same service costs 3.1 times more in Hawaii 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· 32nd of 51
$67.61
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.