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 $141.25 Median $186.21 Typical High $186.21 | Professional | None | $141.25 | $186.21 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $302.00 Median $389.05 Typical High $741.31 | Facility | None | $302.00 | $389.05 | $741.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $128.82 Typical High $138.04 | Professional | None | $125.89 | $128.82 | $138.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | RR · Rental | $12.59 | $12.59 | $13.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $223.87 | Facility | None | $177.83 | $177.83 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $269.15 Typical High $354.81 | Professional | None | $120.23 | $269.15 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | None | $158.49 | $186.21 | $186.21 |
United Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $186.21 | Facility | None | $177.83 | $177.83 | $186.21 |
United Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $426.58 | Professional | None | $120.23 | $154.88 | $426.58 |
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 $83.18 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $83.18 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $33.11 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $18.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $93.33 Typical High $93.33 | Professional | 52 · Reduced service | $83.18 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $37.15 Typical High $37.15 | Professional | 53 · Discontinued | $33.11 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $28.18 Typical High $28.18 | Professional | 55 · Aftercare only | $24.55 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $18.62 Typical High $18.62 | Professional | 56 · Pre-op care only | $16.60 | $18.62 | $18.62 |
Where Maine sits
The same service costs 3.5 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· 39th of 51
$145
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.