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 $363.08 Median $501.19 Typical High $501.19 | Professional | None | $363.08 | $501.19 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Facility | None | $812.83 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $389.05 Typical High $416.87 | Professional | None | $380.19 | $389.05 | $416.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | RR · Rental | $38.02 | $38.02 | $41.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | UE · Used equipment | $281.84 | $281.84 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $616.60 | Facility | None | $524.81 | $524.81 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $524.81 | Professional | None | $380.19 | $380.19 | $524.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $954.99 | Professional | None | $323.59 | $724.44 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $501.19 Typical High $501.19 | Professional | None | $363.08 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Facility | None | $389.05 | $389.05 | $416.87 |
United Setting Professional Modifier None Typical Low $309.03 Median $416.87 Typical High $1,148.15 | Professional | None | $309.03 | $416.87 | $1,148.15 |
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 $186.21 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $186.21 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $37.15 | $50.12 | $50.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $186.21 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $75.86 | $100.00 | $100.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $56.23 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $37.15 | $50.12 | $50.12 |
Where Maine sits
The same service costs 2.8 times more in Hawaii than in Maryland. 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· 30th of 51
$398
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.