How much rates vary
Facilitymedian $2,291 · 10th to 90th $1,288 to $4,365Professionalmedian $851 · 10th to 90th $646 to $1,585
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 $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,819.70 | $2,290.87 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $831.76 Typical High $891.25 | Professional | None | $707.95 | $831.76 | $891.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $83.18 Median $83.18 Typical High $91.20 | Professional | RR · Rental | $83.18 | $83.18 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $691.83 | Professional | UE · Used equipment | $616.60 | $616.60 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,348.96 | Facility | None | $891.25 | $891.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,089.30 | Professional | None | $707.95 | $1,584.89 | $2,089.30 |
Martin's Point Setting Professional Modifier None Typical Low $831.76 Median $1,122.02 Typical High $1,122.02 | Professional | None | $831.76 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $870.96 | Facility | None | $851.14 | $851.14 | $870.96 |
United Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $2,511.89 | Professional | None | $676.08 | $912.01 | $2,511.89 |
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 $436.52 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $173.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $436.52 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $173.78 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $128.82 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $87.10 | $112.20 | $112.20 |
Where Maine sits
The same service costs 3.0 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· 36th of 51
$851
HI $1,905DE $646
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.