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 $151.36 Median $208.93 Typical High $208.93 | Professional | None | $151.36 | $208.93 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $831.76 | Facility | None | $338.84 | $436.52 | $831.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $162.18 Typical High $173.78 | Professional | None | $158.49 | $162.18 | $173.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | RR · Rental | $15.85 | $15.85 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | UE · Used equipment | $117.49 | $117.49 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Facility | None | $190.55 | $190.55 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $134.90 Median $302.00 Typical High $398.11 | Professional | None | $134.90 | $302.00 | $398.11 |
Martin's Point Setting Professional Modifier None Typical Low $154.88 Median $208.93 Typical High $208.93 | Professional | None | $154.88 | $208.93 | $208.93 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $151.36 | Facility | None | $147.91 | $147.91 | $151.36 |
United Setting Professional Modifier None Typical Low $128.82 Median $173.78 Typical High $478.63 | Professional | None | $128.82 | $173.78 | $478.63 |
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 $83.18 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $33.11 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $104.71 Typical High $104.71 | Professional | 52 · Reduced service | $83.18 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 53 · Discontinued | $33.11 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | 55 · Aftercare only | $24.55 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $20.89 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $20.89 |
Where Maine sits
The same service costs 2.3 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· 31st of 51
$162
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.