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 $257.04 Median $338.84 Typical High $338.84 | Professional | None | $257.04 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $707.95 Typical High $1,348.96 | Facility | None | $549.54 | $707.95 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $338.84 | Professional | None | $281.84 | $309.03 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $30.90 Typical High $33.88 | Professional | RR · Rental | $28.18 | $30.90 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $213.80 Median $229.09 Typical High $251.19 | Professional | UE · Used equipment | $213.80 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Facility | None | $363.08 | $363.08 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $218.78 Median $489.78 Typical High $645.65 | Professional | None | $218.78 | $489.78 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $338.84 | Professional | None | $288.40 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $363.08 | Facility | None | $338.84 | $338.84 | $363.08 |
United Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $776.25 | Professional | None | $218.78 | $281.84 | $776.25 |
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 $154.88 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $154.88 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $154.88 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $67.61 | Professional | 53 · Discontinued | $61.66 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $45.71 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $33.88 |
Where Maine sits
The same service costs 3.3 times more in Hawaii than in West Virginia. 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
$309
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.