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 $186.21 Median $218.78 Typical High $218.78 | Professional | None | $186.21 | $218.78 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $354.81 Median $457.09 Typical High $851.14 | Facility | None | $354.81 | $457.09 | $851.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | None | $186.21 | $186.21 | $204.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.62 Median $18.62 Typical High $20.42 | Professional | RR · Rental | $18.62 | $18.62 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | UE · Used equipment | $138.04 | $138.04 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Facility | None | $190.55 | $190.55 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $190.55 | Professional | None | $138.04 | $138.04 | $190.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $407.38 | Professional | None | $141.25 | $316.23 | $407.38 |
Martin's Point Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $218.78 | Professional | None | $186.21 | $218.78 | $218.78 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $173.78 | Facility | None | $125.89 | $125.89 | $173.78 |
United Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $501.19 | Professional | None | $141.25 | $177.83 | $501.19 |
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 $93.33 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $109.65 Typical High $109.65 | Professional | 52 · Reduced service | $93.33 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 53 · Discontinued | $37.15 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $32.36 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $32.36 | $32.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $21.88 |
Where Maine sits
The same service costs 2.7 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· 31st of 51
$186
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.