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 $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $660.69 Typical High $1,258.93 | Facility | None | $512.86 | $660.69 | $1,258.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $331.13 | Professional | None | $302.00 | $302.00 | $331.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | RR · Rental | $30.20 | $30.20 | $33.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $223.87 Median $223.87 Typical High $245.47 | Professional | UE · Used equipment | $223.87 | $223.87 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $389.05 Typical High $389.05 | Facility | None | $363.08 | $389.05 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $204.17 Median $457.09 Typical High $602.56 | Professional | None | $204.17 | $457.09 | $602.56 |
Martin's Point Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $316.23 | Professional | None | $309.03 | $316.23 | $316.23 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $426.58 | Facility | None | $331.13 | $331.13 | $426.58 |
United Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $724.44 | Professional | None | $204.17 | $257.04 | $724.44 |
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 $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $154.88 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $63.10 Typical High $63.10 | Professional | 53 · Discontinued | $61.66 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $46.77 Typical High $46.77 | Professional | 55 · Aftercare only | $45.71 | $46.77 | $46.77 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $30.90 | $31.62 | $31.62 |
Where Maine sits
The same service costs 3.4 times more in Hawaii than in Washington, DC. 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· 25th of 51
$309
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.