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 $812.83 Median $977.24 Typical High $977.24 | Professional | None | $812.83 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,584.89 Median $2,041.74 Typical High $3,890.45 | Facility | None | $1,584.89 | $2,041.74 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | None | $794.33 | $794.33 | $870.96 |
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 $645.65 | Professional | UE · Used equipment | $588.84 | $588.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $1,202.26 | Facility | None | $851.14 | $851.14 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $630.96 Median $1,412.54 Typical High $1,862.09 | Professional | None | $630.96 | $1,412.54 | $1,862.09 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $977.24 | Professional | None | $812.83 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Facility | None | $630.96 | $630.96 | $776.25 |
United Setting Professional Modifier None Typical Low $630.96 Median $812.83 Typical High $2,238.72 | Professional | None | $630.96 | $812.83 | $2,238.72 |
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 $426.58 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $426.58 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $426.58 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $169.82 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $169.82 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $125.89 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $85.11 | $97.72 | $97.72 |
Where Maine sits
The same service costs 3.0 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· 31st of 51
$813
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.