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 $436.52 Median $602.56 Typical High $602.56 | Professional | None | $436.52 | $602.56 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $2,344.23 | Facility | None | $977.24 | $1,258.93 | $2,344.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $501.19 | Professional | None | $489.78 | $489.78 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | RR · Rental | $48.98 | $48.98 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | UE · Used equipment | $363.08 | $363.08 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $724.44 | Facility | None | $501.19 | $501.19 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $389.05 Median $870.96 Typical High $1,122.02 | Professional | None | $389.05 | $870.96 | $1,122.02 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | None | $446.68 | $602.56 | $602.56 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $562.34 | Facility | None | $537.03 | $537.03 | $562.34 |
United Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,380.38 | Professional | None | $389.05 | $489.78 | $1,380.38 |
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 $239.88 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $302.00 Typical High $302.00 | Professional | 52 · Reduced service | $239.88 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $120.23 | Professional | 53 · Discontinued | $95.50 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $60.26 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $60.26 |
Where Maine sits
The same service costs 3.9 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· 29th of 51
$501
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.