How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,950 to $6,761Professionalmedian $1,288 · 10th to 90th $955 to $2,455
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 $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $6,760.83 | Facility | None | $2,754.23 | $3,548.13 | $6,760.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Professional | None | $1,258.93 | $1,258.93 | $1,348.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | RR · Rental | $125.89 | $125.89 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | UE · Used equipment | $954.99 | $954.99 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $2,041.74 | Facility | None | $1,318.26 | $1,318.26 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,096.48 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,096.48 | $2,454.71 | $3,162.28 |
Martin's Point Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,698.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,258.93 | Facility | None | $1,122.02 | $1,122.02 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,380.38 Typical High $3,890.45 | Professional | None | $1,023.29 | $1,380.38 | $3,890.45 |
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 $645.65 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $645.65 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $257.04 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $190.55 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $128.82 | $169.82 | $169.82 |
Where Maine sits
The same service costs 2.9 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· 35th of 51
$1,288
HI $2,754DE $955
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.