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 $75.86 Median $83.18 Typical High $83.18 | Professional | None | $75.86 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $134.90 Median $173.78 Typical High $323.59 | Facility | None | $134.90 | $173.78 | $323.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $83.18 | Professional | None | $75.86 | $75.86 | $83.18 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | RR · Rental | $7.59 | $7.59 | $8.32 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | UE · Used equipment | $57.54 | $57.54 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $104.71 Typical High $104.71 | Facility | None | $95.50 | $104.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $104.71 | Professional | None | $75.86 | $75.86 | $104.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $53.70 Median $120.23 Typical High $154.88 | Professional | None | $53.70 | $120.23 | $154.88 |
Martin's Point Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $83.18 | Professional | None | $75.86 | $83.18 | $83.18 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $85.11 | Facility | None | $75.86 | $75.86 | $85.11 |
United Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $162.18 | Professional | None | $53.70 | $67.61 | $162.18 |
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 $39.81 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $39.81 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.85 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.32 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $39.81 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $15.85 | $16.60 | $16.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $11.75 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $7.94 | $8.32 | $8.32 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in Florida. 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· 48th of 51
$75.86
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.