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 $104.71 Median $114.82 Typical High $114.82 | Professional | None | $104.71 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $457.09 | Facility | None | $186.21 | $239.88 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $123.03 | Professional | None | $114.82 | $114.82 | $123.03 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | RR · Rental | $11.48 | $11.48 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $85.11 Median $85.11 Typical High $93.33 | Professional | UE · Used equipment | $85.11 | $85.11 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $144.54 | Facility | None | $128.82 | $128.82 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $128.82 | Professional | None | $95.50 | $95.50 | $128.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $218.78 | Professional | None | $74.13 | $165.96 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $114.82 Typical High $114.82 | Professional | None | $104.71 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $263.03 | Professional | None | $74.13 | $95.50 | $263.03 |
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 $54.95 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $54.95 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $21.88 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $16.60 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $10.96 | $11.48 | $11.48 |
Where Maine sits
The same service costs 2.5 times more in Kansas than in Utah. 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· 32nd of 51
$115
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.