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 $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $295.12 Typical High $549.54 | Facility | None | $229.09 | $295.12 | $549.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | None | $138.04 | $138.04 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | RR · Rental | $13.80 | $13.80 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | UE · Used equipment | $102.33 | $102.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $165.96 Typical High $169.82 | Facility | None | $162.18 | $165.96 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $95.50 Median $204.17 Typical High $263.03 | Professional | None | $95.50 | $204.17 | $263.03 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | None | $141.25 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $213.80 | Facility | None | $154.88 | $154.88 | $213.80 |
United Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $323.59 | Professional | None | $91.20 | $114.82 | $323.59 |
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 $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Where Maine sits
The same service costs 4.4 times more in Hawaii 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· 36th of 51
$141
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.