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 $52.48 Median $70.79 Typical High $70.79 | Professional | None | $52.48 | $70.79 | $70.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $275.42 | Facility | None | $114.82 | $147.91 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | None | $57.54 | $57.54 | $63.10 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.75 Median $5.75 Typical High $6.31 | Professional | RR · Rental | $5.75 | $5.75 | $6.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | UE · Used equipment | $42.66 | $42.66 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $85.11 | Facility | None | $81.28 | $81.28 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $81.28 | Professional | None | $58.88 | $58.88 | $81.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $131.83 | Professional | None | $45.71 | $102.33 | $131.83 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $70.79 Typical High $70.79 | Professional | None | $52.48 | $70.79 | $70.79 |
United Setting Facility Modifier None Typical Low $63.10 Median $63.10 Typical High $93.33 | Facility | None | $63.10 | $63.10 | $93.33 |
United Setting Professional Modifier None Typical Low $45.71 Median $57.54 Typical High $162.18 | Professional | None | $45.71 | $57.54 | $162.18 |
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 $28.18 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $11.22 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $28.18 | $35.48 | $35.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $11.22 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.47 Typical High $10.47 | Professional | 55 · Aftercare only | $8.51 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.62 | $7.08 | $7.08 |
Where Maine sits
The same service costs 4.4 times more in Hawaii than in Florida. 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· 28th of 51
$58.88
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.