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 $58.88 Median $79.43 Typical High $134.90 | Professional | None | $58.88 | $79.43 | $134.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $128.82 Median $165.96 Typical High $309.03 | Facility | None | $128.82 | $165.96 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $58.88 Median $60.26 Typical High $64.57 | Professional | None | $58.88 | $60.26 | $64.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | RR · Rental | $5.89 | $5.89 | $6.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | UE · Used equipment | $44.67 | $44.67 | $48.98 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $95.50 | Facility | None | $72.44 | $72.44 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $72.44 | Professional | None | $52.48 | $52.48 | $72.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $114.82 Typical High $147.91 | Professional | None | $51.29 | $114.82 | $147.91 |
Martin's Point Setting Professional Modifier None Typical Low $58.88 Median $79.43 Typical High $134.90 | Professional | None | $58.88 | $79.43 | $134.90 |
United Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $100.00 | Facility | None | $64.57 | $64.57 | $100.00 |
United Setting Professional Modifier None Typical Low $45.71 Median $64.57 Typical High $177.83 | Professional | None | $45.71 | $64.57 | $177.83 |
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 $35.48 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.13 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $35.48 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $14.13 | $15.85 | $15.85 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $7.94 |
Where Maine sits
The same service costs 5.0 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· 30th of 51
$63.10
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.