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 $74.13 Median $104.71 Typical High $104.71 | Professional | None | $74.13 | $104.71 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $407.38 | Facility | None | $169.82 | $218.78 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $97.72 | Professional | None | $89.13 | $91.20 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.91 Median $8.91 Typical High $9.77 | Professional | RR · Rental | $8.91 | $8.91 | $9.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | UE · Used equipment | $66.07 | $66.07 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Facility | None | $97.72 | $97.72 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $67.61 Median $151.36 Typical High $194.98 | Professional | None | $67.61 | $151.36 | $194.98 |
Martin's Point Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $104.71 | Professional | None | $75.86 | $104.71 | $104.71 |
United Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $89.13 | Facility | None | $79.43 | $79.43 | $89.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $85.11 Typical High $239.88 | Professional | None | $67.61 | $85.11 | $239.88 |
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 $44.67 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $44.67 | $52.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $17.78 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $44.67 Median $52.48 Typical High $52.48 | Professional | 52 · Reduced service | $44.67 | $52.48 | $52.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $17.78 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.91 | $10.47 | $10.47 |
Where Maine sits
The same service costs 2.8 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· 38th of 51
$91.20
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.