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 $134.90 Median $138.04 Typical High $138.04 | Professional | None | $134.90 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $537.03 | Facility | None | $223.87 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | None | $134.90 | $134.90 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | RR · Rental | $13.49 | $13.49 | $14.79 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | UE · Used equipment | $100.00 | $100.00 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $165.96 | Facility | None | $141.25 | $141.25 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $199.53 Typical High $257.04 | Professional | None | $93.33 | $199.53 | $257.04 |
Martin's Point Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | None | $134.90 | $138.04 | $138.04 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $389.05 | Facility | None | $151.36 | $151.36 | $389.05 |
United Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $316.23 | Professional | None | $89.13 | $112.20 | $316.23 |
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 $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 52 · Reduced service | $69.18 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 53 · Discontinued | $27.54 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $20.42 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $13.80 |
Where Maine sits
The same service costs 8.1 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· 27th of 51
$138
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.