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 $30.90 Median $42.66 Typical High $42.66 | Professional | None | $30.90 | $42.66 | $42.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $169.82 | Facility | None | $69.18 | $89.13 | $169.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $36.31 Median $37.15 Typical High $39.81 | Professional | None | $36.31 | $37.15 | $39.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.63 Median $3.63 Typical High $3.98 | Professional | RR · Rental | $3.63 | $3.63 | $3.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | UE · Used equipment | $27.54 | $27.54 | $30.20 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $52.48 | Facility | None | $48.98 | $48.98 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $48.98 | Professional | None | $35.48 | $35.48 | $48.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $27.54 Median $61.66 Typical High $81.28 | Professional | None | $27.54 | $61.66 | $81.28 |
Martin's Point Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $42.66 | Professional | None | $36.31 | $42.66 | $42.66 |
United Setting Facility Modifier None Typical Low $40.74 Median $40.74 Typical High $52.48 | Facility | None | $40.74 | $40.74 | $52.48 |
United Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $97.72 | Professional | None | $27.54 | $35.48 | $97.72 |
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 $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.62 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $21.38 Typical High $21.38 | Professional | 52 · Reduced service | $18.62 | $21.38 | $21.38 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $7.41 | $8.51 | $8.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $6.46 Typical High $6.46 | Professional | 55 · Aftercare only | $5.62 | $6.46 | $6.46 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.72 | $4.27 | $4.27 |
Where Maine sits
The same service costs 4.0 times more in Hawaii than in Washington, DC. 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· 33rd of 51
$37.15
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.