How much rates vary
Facilitymedian $2,951 · 10th to 90th $1,660 to $5,754Professionalmedian $1,096 · 10th to 90th $955 to $2,089
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 $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $5,754.40 | Facility | None | $2,344.23 | $3,019.95 | $5,754.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | None | $1,096.48 | $1,096.48 | $1,202.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $109.65 Median $109.65 Typical High $120.23 | Professional | RR · Rental | $109.65 | $109.65 | $120.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | UE · Used equipment | $812.83 | $812.83 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,737.80 | Facility | None | $1,380.38 | $1,380.38 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,023.29 | $1,380.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $933.25 Median $2,089.30 Typical High $2,754.23 | Professional | None | $933.25 | $2,089.30 | $2,754.23 |
Martin's Point Setting Professional Modifier None Typical Low $1,071.52 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,071.52 | $1,445.44 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,174.90 | Facility | None | $1,000.00 | $1,000.00 | $1,174.90 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,174.90 Typical High $3,311.31 | Professional | None | $891.25 | $1,174.90 | $3,311.31 |
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 $537.03 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $537.03 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $537.03 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $213.80 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $162.18 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $107.15 | $144.54 | $144.54 |
Where Maine sits
The same service costs 2.7 times more in Hawaii than in Florida. 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· 25th of 51
$1,175
HI $2,630FL $977
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.