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 $151.36 Median $204.17 Typical High $204.17 | Professional | None | $151.36 | $204.17 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $812.83 | Facility | None | $331.13 | $426.58 | $812.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | None | $154.88 | $154.88 | $169.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $15.49 Typical High $16.98 | Professional | RR · Rental | $15.49 | $15.49 | $16.98 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | UE · Used equipment | $117.49 | $117.49 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $251.19 | Facility | None | $158.49 | $158.49 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $131.83 Median $295.12 Typical High $389.05 | Professional | None | $131.83 | $295.12 | $389.05 |
Martin's Point Setting Professional Modifier None Typical Low $151.36 Median $204.17 Typical High $204.17 | Professional | None | $151.36 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | None | $141.25 | $141.25 | $169.82 |
United Setting Professional Modifier None Typical Low $128.82 Median $169.82 Typical High $467.74 | Professional | None | $128.82 | $169.82 | $467.74 |
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 $77.62 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $77.62 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | 52 · Reduced service | $77.62 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $40.74 Typical High $40.74 | Professional | 53 · Discontinued | $30.90 | $40.74 | $40.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $30.90 Typical High $30.90 | Professional | 55 · Aftercare only | $22.91 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $20.42 Typical High $20.42 | Professional | 56 · Pre-op care only | $15.49 | $20.42 | $20.42 |
Where Maine sits
The same service costs 4.4 times more in Hawaii than in Kansas. 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· 26th of 51
$166
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.