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 $288.40 Median $389.05 Typical High $389.05 | Professional | None | $288.40 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $1,513.56 | Facility | None | $630.96 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $295.12 Typical High $316.23 | Professional | None | $288.40 | $295.12 | $316.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | RR · Rental | $28.84 | $28.84 | $31.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $239.88 | Professional | UE · Used equipment | $218.78 | $218.78 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $467.74 | Facility | None | $295.12 | $295.12 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $245.47 Median $549.54 Typical High $724.44 | Professional | None | $245.47 | $549.54 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $389.05 | Professional | None | $288.40 | $389.05 | $389.05 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $346.74 | Facility | None | $316.23 | $316.23 | $346.74 |
United Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $870.96 | Professional | None | $223.87 | $316.23 | $870.96 |
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 $151.36 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $151.36 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $77.62 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $151.36 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $77.62 | Professional | 53 · Discontinued | $60.26 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $57.54 Typical High $57.54 | Professional | 55 · Aftercare only | $45.71 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $38.90 |
Where Maine sits
The same service costs 4.2 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· 25th of 51
$302
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.