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 $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $245.47 | Facility | None | $102.33 | $128.82 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $58.88 | Professional | None | $47.86 | $56.23 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | RR · Rental | $5.62 | $5.62 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | UE · Used equipment | $42.66 | $42.66 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $75.86 | Facility | None | $67.61 | $67.61 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $117.49 | Professional | None | $39.81 | $89.13 | $117.49 |
Martin's Point Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $61.66 | Professional | None | $56.23 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $60.26 | Facility | None | $32.36 | $32.36 | $60.26 |
United Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $141.25 | Professional | None | $39.81 | $51.29 | $141.25 |
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 $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $29.51 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $29.51 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.59 Typical High $12.59 | Professional | 53 · Discontinued | $12.02 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.91 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.89 | $6.17 | $6.17 |
Where Maine sits
The same service costs 2.1 times more in Montana 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· 27th of 51
$58.88
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.