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 $128.82 Median $141.25 Typical High $147.91 | Professional | None | $128.82 | $141.25 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $295.12 Typical High $562.34 | Facility | None | $229.09 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $117.49 Typical High $125.89 | Professional | None | $114.82 | $117.49 | $125.89 |
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 $151.36 Median $151.36 Typical High $169.82 | Facility | None | $151.36 | $151.36 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Professional | None | $112.20 | $112.20 | $151.36 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $91.20 Median $204.17 Typical High $269.15 | Professional | None | $91.20 | $204.17 | $269.15 |
Martin's Point Setting Professional Modifier None Typical Low $128.82 Median $141.25 Typical High $147.91 | Professional | None | $128.82 | $141.25 | $147.91 |
United Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $323.59 | Professional | None | $91.20 | $117.49 | $323.59 |
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 $67.61 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $67.61 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $26.92 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $67.61 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $26.92 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $20.42 | $21.38 | $21.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $13.49 | $14.13 | $14.13 |
Where Maine sits
The same service costs 2.1 times more in Hawaii 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· 45th of 51
$117
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.