How much rates vary
Facilitymedian $1,862 · 10th to 90th $1,148 to $3,631Professionalmedian $912 · 10th to 90th $724 to $1,318
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 $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,513.56 | $1,905.46 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | RR · Rental | $91.20 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | UE · Used equipment | $676.08 | $676.08 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,148.15 | Facility | None | $1,071.52 | $1,148.15 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,148.15 | Professional | None | $831.76 | $831.76 | $1,148.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $1,318.26 Typical High $1,737.80 | Professional | None | $616.60 | $1,318.26 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $912.01 Typical High $912.01 | Professional | None | $891.25 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,258.93 | Facility | None | $1,000.00 | $1,000.00 | $1,258.93 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $2,089.30 | Professional | None | $588.84 | $758.58 | $2,089.30 |
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 $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $446.68 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $186.21 | Professional | 53 · Discontinued | $177.83 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | 55 · Aftercare only | $134.90 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $89.13 | $91.20 | $91.20 |
Where Maine sits
The same service costs 3.9 times more in Hawaii than in West Virginia. 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· 34th of 51
$912
HI $3,236WV $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.