How much rates vary
Facilitymedian $2,089 · 10th to 90th $1,175 to $3,981Professionalmedian $794 · 10th to 90th $603 to $1,479
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 $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | None | $741.31 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,659.59 Median $2,137.96 Typical High $3,981.07 | Facility | None | $1,659.59 | $2,137.96 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $812.83 | Professional | None | $676.08 | $794.33 | $812.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | RR · Rental | $79.43 | $79.43 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $588.84 Typical High $660.69 | Professional | UE · Used equipment | $588.84 | $588.84 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,230.27 | Facility | None | $831.76 | $831.76 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $660.69 Median $1,479.11 Typical High $1,905.46 | Professional | None | $660.69 | $1,479.11 | $1,905.46 |
Martin's Point Setting Professional Modifier None Typical Low $741.31 Median $1,023.29 Typical High $1,023.29 | Professional | None | $741.31 | $1,023.29 | $1,023.29 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,348.96 | Facility | None | $870.96 | $870.96 | $1,348.96 |
United Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $2,290.87 | Professional | None | $660.69 | $831.76 | $2,290.87 |
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 $398.11 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $398.11 Median $512.86 Typical High $512.86 | Professional | 52 · Reduced service | $398.11 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $204.17 Typical High $204.17 | Professional | 53 · Discontinued | $158.49 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $151.36 Typical High $151.36 | Professional | 55 · Aftercare only | $117.49 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $102.33 Typical High $102.33 | Professional | 56 · Pre-op care only | $79.43 | $102.33 | $102.33 |
Where Maine sits
The same service costs 5.4 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· 28th of 51
$813
HI $3,236DE $603
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.