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 $61.66 Median $85.11 Typical High $85.11 | Professional | None | $61.66 | $85.11 | $85.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $138.04 Median $177.83 Typical High $338.84 | Facility | None | $138.04 | $177.83 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $70.79 | Professional | None | $64.57 | $66.07 | $70.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $6.46 Typical High $7.08 | Professional | RR · Rental | $6.46 | $6.46 | $7.08 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | UE · Used equipment | $47.86 | $47.86 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $104.71 | Facility | None | $69.18 | $69.18 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $69.18 | Professional | None | $50.12 | $50.12 | $69.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $54.95 Median $123.03 Typical High $162.18 | Professional | None | $54.95 | $123.03 | $162.18 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $85.11 | Professional | None | $63.10 | $85.11 | $85.11 |
United Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $83.18 | Facility | None | $70.79 | $70.79 | $83.18 |
United Setting Professional Modifier None Typical Low $48.98 Median $70.79 Typical High $194.98 | Professional | None | $48.98 | $70.79 | $194.98 |
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 $39.81 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $39.81 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $15.85 | $16.98 | $16.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.75 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.94 | $8.51 | $8.51 |
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· 30th of 51
$67.61
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.