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 $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $57.54 Median $74.13 Typical High $141.25 | Facility | None | $57.54 | $74.13 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $29.51 Median $34.67 Typical High $37.15 | Professional | None | $29.51 | $34.67 | $37.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | RR · Rental | $3.47 | $3.47 | $3.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | UE · Used equipment | $26.30 | $26.30 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Facility | None | $38.90 | $38.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $38.90 | Professional | None | $28.18 | $28.18 | $38.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.99 Median $51.29 Typical High $67.61 | Professional | None | $23.99 | $51.29 | $67.61 |
Martin's Point Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
United Setting Facility Modifier None Typical Low $35.48 Median $35.48 Typical High $38.02 | Facility | None | $35.48 | $35.48 | $38.02 |
United Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $81.28 | Professional | None | $22.91 | $28.84 | $81.28 |
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 $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | 52 · Reduced service | $17.78 | $17.78 | $17.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 53 · Discontinued | $7.08 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $3.55 |
Where Maine sits
The same service costs 3.0 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· 32nd of 51
$35.48
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.