How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,413 to $4,786Professionalmedian $1,148 · 10th to 90th $933 to $1,738
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 $1,096.48 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $4,786.30 | Facility | None | $1,995.26 | $2,511.89 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,230.27 | Professional | None | $977.24 | $1,148.15 | $1,230.27 |
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 $1,288.25 Median $1,288.25 Typical High $1,479.11 | Facility | None | $1,288.25 | $1,288.25 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,288.25 | Professional | None | $933.25 | $933.25 | $1,288.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $776.25 Median $1,737.80 Typical High $2,290.87 | Professional | None | $776.25 | $1,737.80 | $2,290.87 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,122.02 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,318.26 | Facility | None | $1,258.93 | $1,258.93 | $1,318.26 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $2,754.23 | Professional | None | $776.25 | $1,000.00 | $2,754.23 |
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 $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $602.56 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $245.47 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $181.97 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $120.23 |
Where Maine sits
The same service costs 3.2 times more in Hawaii than in Alabama. 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
$1,175
HI $3,020AL $933
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.