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 $218.78 Median $302.00 Typical High $302.00 | Professional | None | $218.78 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $1,202.26 | Facility | None | $489.78 | $630.96 | $1,202.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $223.87 Typical High $239.88 | Professional | None | $190.55 | $223.87 | $239.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.39 Median $22.39 Typical High $24.55 | Professional | RR · Rental | $22.39 | $22.39 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | UE · Used equipment | $165.96 | $165.96 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $234.42 Typical High $363.08 | Facility | None | $234.42 | $234.42 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $234.42 | Professional | None | $173.78 | $173.78 | $234.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $194.98 Median $436.52 Typical High $562.34 | Professional | None | $194.98 | $436.52 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $302.00 | Professional | None | $218.78 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $380.19 | Facility | None | $251.19 | $251.19 | $380.19 |
United Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $691.83 | Professional | None | $177.83 | $245.47 | $691.83 |
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 $114.82 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $114.82 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $45.71 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $44.67 Typical High $44.67 | Professional | 55 · Aftercare only | $33.88 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.91 | $30.20 | $30.20 |
Where Maine sits
The same service costs 5.5 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· 35th of 51
$229
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.