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 $457.09 Median $549.54 Typical High $549.54 | Professional | None | $457.09 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,187.76 | Facility | None | $891.25 | $1,148.15 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $501.19 | Professional | None | $416.87 | $489.78 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $48.98 Median $48.98 Typical High $53.70 | Professional | RR · Rental | $48.98 | $48.98 | $53.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | UE · Used equipment | $363.08 | $363.08 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $676.08 | Facility | None | $512.86 | $512.86 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $512.86 | Professional | None | $371.54 | $371.54 | $512.86 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $354.81 Median $794.33 Typical High $1,047.13 | Professional | None | $354.81 | $794.33 | $1,047.13 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $549.54 Typical High $549.54 | Professional | None | $457.09 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $549.54 | Facility | None | $478.63 | $478.63 | $549.54 |
United Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $1,258.93 | Professional | None | $354.81 | $457.09 | $1,258.93 |
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 $245.47 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $245.47 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $97.72 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $74.13 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $48.98 | $54.95 | $54.95 |
Where Maine sits
The same service costs 3.2 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· 30th of 51
$501
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.