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 $51.29 Median $63.10 Typical High $77.62 | Professional | None | $51.29 | $63.10 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $131.83 Typical High $251.19 | Facility | None | $102.33 | $131.83 | $251.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | RR · Rental | $5.50 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | UE · Used equipment | $40.74 | $40.74 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $75.86 | Facility | None | $57.54 | $57.54 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $57.54 | Professional | None | $42.66 | $42.66 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $91.20 Typical High $120.23 | Professional | None | $40.74 | $91.20 | $120.23 |
Martin's Point Setting Professional Modifier None Typical Low $53.70 Median $63.10 Typical High $77.62 | Professional | None | $53.70 | $63.10 | $77.62 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Facility | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $40.74 Median $51.29 Typical High $144.54 | Professional | None | $40.74 | $51.29 | $144.54 |
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 $27.54 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $27.54 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.22 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.32 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $6.31 | $6.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $31.62 Typical High $31.62 | Professional | 52 · Reduced service | $27.54 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $11.22 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.32 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.31 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.62 | $6.31 | $6.31 |
Where Maine sits
The same service costs 2.6 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· 32nd of 51
$56.23
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.