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 $724.44 Median $891.25 Typical High $891.25 | Professional | None | $724.44 | $891.25 | $891.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $3,467.37 | Facility | None | $1,445.44 | $1,862.09 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $912.01 | Professional | None | $831.76 | $851.14 | $912.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | RR · Rental | $83.18 | $83.18 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | UE · Used equipment | $616.60 | $616.60 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $954.99 | Facility | None | $831.76 | $831.76 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $831.76 | Professional | None | $616.60 | $616.60 | $831.76 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $575.44 Median $1,288.25 Typical High $1,659.59 | Professional | None | $575.44 | $1,288.25 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $891.25 | Professional | None | $758.58 | $891.25 | $891.25 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $794.33 | Facility | None | $630.96 | $630.96 | $794.33 |
United Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $2,041.74 | Professional | None | $575.44 | $724.44 | $2,041.74 |
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 $380.19 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $446.68 Typical High $446.68 | Professional | 52 · Reduced service | $380.19 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $177.83 | Professional | 53 · Discontinued | $151.36 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $131.83 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $89.13 |
Where Maine sits
The same service costs 3.2 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· 22nd of 51
$851
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.