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 $776.25 Median $831.76 Typical High $831.76 | Professional | None | $776.25 | $831.76 | $831.76 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $3,311.31 | Facility | None | $1,348.96 | $1,737.80 | $3,311.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $831.76 | Professional | None | $676.08 | $812.83 | $831.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | RR · Rental | $81.28 | $81.28 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $660.69 | Professional | UE · Used equipment | $602.56 | $602.56 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,000.00 | Facility | None | $851.14 | $851.14 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $851.14 | Professional | None | $630.96 | $630.96 | $851.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $575.44 Median $1,202.26 Typical High $1,584.89 | Professional | None | $575.44 | $1,202.26 | $1,584.89 |
Martin's Point Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | None | $776.25 | $831.76 | $831.76 |
United Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,318.26 | Facility | None | $912.01 | $912.01 | $1,318.26 |
United Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,905.46 | Professional | None | $537.03 | $691.83 | $1,905.46 |
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 $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $416.87 | $416.87 | $416.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $165.96 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $123.03 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $83.18 | $83.18 | $83.18 |
Where Maine sits
The same service costs 5.1 times more in Hawaii than in Delaware. 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· 29th of 51
$832
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.