How much rates vary
Facilitymedian $2,754 · 10th to 90th $1,549 to $5,248Professionalmedian $1,148 · 10th to 90th $851 to $1,905
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 $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,187.76 Median $2,754.23 Typical High $5,248.07 | Facility | None | $2,187.76 | $2,754.23 | $5,248.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,258.93 | Professional | None | $1,148.15 | $1,148.15 | $1,258.93 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $114.82 Median $114.82 Typical High $125.89 | Professional | RR · Rental | $114.82 | $114.82 | $125.89 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | UE · Used equipment | $851.14 | $851.14 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,621.81 | Facility | None | $1,174.90 | $1,174.90 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,174.90 | Professional | None | $851.14 | $851.14 | $1,174.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $851.14 Median $1,905.46 Typical High $2,511.89 | Professional | None | $851.14 | $1,905.46 | $2,511.89 |
Martin's Point Setting Professional Modifier None Typical Low $1,122.02 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,122.02 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $933.25 | Facility | None | $870.96 | $870.96 | $933.25 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,096.48 Typical High $3,019.95 | Professional | None | $851.14 | $1,096.48 | $3,019.95 |
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 $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $660.69 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $269.15 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $199.53 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $134.90 | $134.90 | $134.90 |
Where Maine sits
The same service costs 3.0 times more in Montana 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· 28th of 51
$1,148
MT $2,570DE $851
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.