How much rates vary
Facilitymedian $2,570 · 10th to 90th $1,479 to $5,012Professionalmedian $1,175 · 10th to 90th $871 to $1,820
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 $933.25 Median $1,258.93 Typical High $1,258.93 | Professional | None | $933.25 | $1,258.93 | $1,258.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $2,630.27 Typical High $5,011.87 | Facility | None | $2,089.30 | $2,630.27 | $5,011.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,174.90 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,174.90 | $1,258.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | RR · Rental | $114.82 | $114.82 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | UE · Used equipment | $851.14 | $851.14 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,548.82 | Facility | None | $1,174.90 | $1,174.90 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,174.90 | Professional | None | $870.96 | $870.96 | $1,174.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,819.70 Typical High $2,398.83 | Professional | None | $812.83 | $1,819.70 | $2,398.83 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,071.52 | $1,258.93 | $1,258.93 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,479.11 | Facility | None | $1,174.90 | $1,174.90 | $1,479.11 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $2,884.03 | Professional | None | $812.83 | $1,047.13 | $2,884.03 |
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 $562.34 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $630.96 Typical High $630.96 | Professional | 52 · Reduced service | $562.34 | $630.96 | $630.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $223.87 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | 55 · Aftercare only | $165.96 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $125.89 Typical High $125.89 | Professional | 56 · Pre-op care only | $112.20 | $125.89 | $125.89 |
Where Maine sits
The same service costs 4.0 times more in Hawaii than in Pennsylvania. 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
$1,175
HI $3,467PA $871
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.