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 $194.98 Median $257.04 Typical High $257.04 | Professional | None | $194.98 | $257.04 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $1,023.29 | Facility | None | $416.87 | $537.03 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $223.87 | Professional | None | $204.17 | $204.17 | $223.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | RR · Rental | $20.42 | $20.42 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | UE · Used equipment | $154.88 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $309.03 | Facility | None | $218.78 | $218.78 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $218.78 | Professional | None | $158.49 | $158.49 | $218.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $371.54 Typical High $489.78 | Professional | None | $165.96 | $371.54 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $257.04 | Professional | None | $190.55 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $169.82 | Facility | None | $36.31 | $36.31 | $169.82 |
United Setting Professional Modifier None Typical Low $165.96 Median $208.93 Typical High $588.84 | Professional | None | $165.96 | $208.93 | $588.84 |
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 $102.33 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $102.33 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $40.74 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $102.33 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $40.74 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $25.70 | $25.70 |
Where Maine sits
The same service costs 3.6 times more in Georgia than in Alaska. 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
$209
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.