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 $77.62 Median $107.15 Typical High $107.15 | Professional | None | $77.62 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $223.87 Typical High $426.58 | Facility | None | $173.78 | $223.87 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $102.33 | Professional | None | $93.33 | $97.72 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | RR · Rental | $9.33 | $9.33 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | UE · Used equipment | $70.79 | $70.79 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $131.83 | Facility | None | $117.49 | $117.49 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $69.18 Median $154.88 Typical High $204.17 | Professional | None | $69.18 | $154.88 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $107.15 | Professional | None | $91.20 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $245.47 | Professional | None | $69.18 | $89.13 | $245.47 |
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 $45.71 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $45.71 Median $53.70 Typical High $53.70 | Professional | 52 · Reduced service | $45.71 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $21.38 Typical High $21.38 | Professional | 53 · Discontinued | $18.20 | $21.38 | $21.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.22 Typical High $16.22 | Professional | 55 · Aftercare only | $13.49 | $16.22 | $16.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.12 | $10.72 | $10.72 |
Where Maine sits
The same service costs 2.4 times more in Hawaii than in Colorado. 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· 30th of 51
$97.72
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.