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 $93.33 Median $102.33 Typical High $102.33 | Professional | None | $93.33 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $407.38 | Facility | None | $165.96 | $213.80 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $100.00 | Professional | None | $77.62 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.12 Median $9.12 Typical High $10.23 | Professional | RR · Rental | $9.12 | $9.12 | $10.23 |
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 $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $117.49 | Professional | None | $85.11 | $85.11 | $117.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $194.98 | Professional | None | $66.07 | $147.91 | $194.98 |
Martin's Point Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $102.33 | Professional | None | $93.33 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $66.07 Median $83.18 Typical High $234.42 | Professional | None | $66.07 | $83.18 | $234.42 |
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 $48.98 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $20.42 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $48.98 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $48.98 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $20.42 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $20.42 | $20.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $14.79 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $9.77 | $10.23 | $10.23 |
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· 31st of 51
$95.50
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.