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 $91.20 Median $117.49 Typical High $117.49 | Professional | None | $91.20 | $117.49 | $117.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $245.47 Typical High $457.09 | Facility | None | $190.55 | $245.47 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $100.00 | Professional | None | $79.43 | $93.33 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | RR · Rental | $9.12 | $9.12 | $10.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | UE · Used equipment | $69.18 | $69.18 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $141.25 | Facility | None | $97.72 | $97.72 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $97.72 | Professional | None | $70.79 | $70.79 | $97.72 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $75.86 Median $169.82 Typical High $218.78 | Professional | None | $75.86 | $169.82 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $117.49 | Professional | None | $91.20 | $117.49 | $117.49 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $100.00 | Facility | None | $95.50 | $95.50 | $100.00 |
United Setting Professional Modifier None Typical Low $70.79 Median $95.50 Typical High $269.15 | Professional | None | $70.79 | $95.50 | $269.15 |
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 $47.86 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $19.05 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $47.86 Median $58.88 Typical High $58.88 | Professional | 52 · Reduced service | $47.86 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $23.44 | Professional | 53 · Discontinued | $19.05 | $23.44 | $23.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $11.75 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $11.75 |
Where Maine sits
The same service costs 3.2 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· 28th of 51
$97.72
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.