How much rates vary
Facilitymedian $1,862 · 10th to 90th $1,047 to $3,631Professionalmedian $813 · 10th to 90th $603 to $1,318
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 $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,905.46 Typical High $3,630.78 | Facility | None | $1,479.11 | $1,905.46 | $3,630.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $891.25 | Professional | None | $812.83 | $812.83 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | RR · Rental | $81.28 | $81.28 | $89.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $602.56 Median $602.56 Typical High $676.08 | Professional | UE · Used equipment | $602.56 | $602.56 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,096.48 | Facility | None | $831.76 | $831.76 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $831.76 | Professional | None | $602.56 | $602.56 | $831.76 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $588.84 Median $1,318.26 Typical High $1,737.80 | Professional | None | $588.84 | $1,318.26 | $1,737.80 |
Martin's Point Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $891.25 | Facility | None | $870.96 | $870.96 | $891.25 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $2,089.30 | Professional | None | $588.84 | $741.31 | $2,089.30 |
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 $416.87 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $416.87 Median $457.09 Typical High $457.09 | Professional | 52 · Reduced service | $416.87 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $181.97 Typical High $181.97 | Professional | 53 · Discontinued | $165.96 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 55 · Aftercare only | $125.89 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 56 · Pre-op care only | $83.18 | $91.20 | $91.20 |
Where Maine sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 26th of 51
$832
HI $2,239KS $513
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.