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 $208.93 Median $281.84 Typical High $281.84 | Professional | None | $208.93 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $457.09 Median $588.84 Typical High $1,096.48 | Facility | None | $457.09 | $588.84 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $229.09 | Professional | None | $177.83 | $208.93 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | RR · Rental | $20.89 | $20.89 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $158.49 Median $158.49 Typical High $173.78 | Professional | UE · Used equipment | $158.49 | $158.49 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $338.84 | Facility | None | $213.80 | $213.80 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $213.80 | Professional | None | $158.49 | $158.49 | $213.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $407.38 Typical High $524.81 | Professional | None | $177.83 | $407.38 | $524.81 |
Martin's Point Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $281.84 | Professional | None | $208.93 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $257.04 | Facility | None | $229.09 | $229.09 | $257.04 |
United Setting Professional Modifier None Typical Low $173.78 Median $229.09 Typical High $630.96 | Professional | None | $173.78 | $229.09 | $630.96 |
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 $107.15 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $107.15 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $42.66 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.38 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $107.15 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $42.66 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $32.36 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $21.38 | $28.18 | $28.18 |
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· 26th of 51
$219
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.