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 $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $912.01 Typical High $1,737.80 | Facility | None | $724.44 | $912.01 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $398.11 | Professional | None | $380.19 | $380.19 | $398.11 |
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 $288.40 Median $288.40 Typical High $316.23 | Professional | UE · Used equipment | $288.40 | $288.40 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $537.03 | Facility | None | $407.38 | $407.38 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $407.38 | Professional | None | $295.12 | $295.12 | $407.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $831.76 | Professional | None | $281.84 | $630.96 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | None | $371.54 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $575.44 | Facility | None | $436.52 | $436.52 | $575.44 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $1,000.00 | Professional | None | $281.84 | $363.08 | $1,000.00 |
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 $194.98 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $194.98 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $79.43 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $58.88 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $44.67 | $44.67 |
Where Maine sits
The same service costs 4.3 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· 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.