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 $83.18 Median $87.10 Typical High $87.10 | Professional | None | $83.18 | $87.10 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $181.97 Typical High $346.74 | Facility | None | $141.25 | $181.97 | $346.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | None | $81.28 | $81.28 | $89.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $8.13 Median $8.13 Typical High $8.91 | Professional | RR · Rental | $8.13 | $8.13 | $8.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | UE · Used equipment | $61.66 | $61.66 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $91.20 | Professional | None | $66.07 | $66.07 | $91.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $165.96 | Professional | None | $57.54 | $125.89 | $165.96 |
Martin's Point Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $87.10 | Professional | None | $83.18 | $87.10 | $87.10 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $69.18 | Facility | None | $39.81 | $39.81 | $69.18 |
United Setting Professional Modifier None Typical Low $56.23 Median $72.44 Typical High $199.53 | Professional | None | $56.23 | $72.44 | $199.53 |
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 $42.66 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $42.66 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $16.98 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 55 · Aftercare only | $12.88 | $13.18 | $13.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $8.51 | $8.71 | $8.71 |
Where Maine sits
The same service costs 2.5 times more in Montana 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· 32nd of 51
$85.11
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.