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 $24.55 Median $30.90 Typical High $30.90 | Professional | None | $24.55 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $50.12 Median $64.57 Typical High $123.03 | Facility | None | $50.12 | $64.57 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $27.54 Median $27.54 Typical High $30.20 | Professional | None | $27.54 | $27.54 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $2.75 Typical High $3.02 | Professional | RR · Rental | $2.75 | $2.75 | $3.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | UE · Used equipment | $20.42 | $20.42 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $34.67 Median $34.67 Typical High $38.90 | Facility | None | $34.67 | $34.67 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $19.95 Median $44.67 Typical High $58.88 | Professional | None | $19.95 | $44.67 | $58.88 |
Martin's Point Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $30.90 | Professional | None | $28.18 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $19.95 Median $25.12 Typical High $70.79 | Professional | None | $19.95 | $25.12 | $70.79 |
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 $14.79 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.89 | $6.17 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.47 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.17 Typical High $6.17 | Professional | 53 · Discontinued | $5.89 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.47 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $2.95 | $3.09 | $3.09 |
Where Maine sits
The same service costs 2.1 times more in Montana than in New Jersey. 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· 37th of 51
$27.54
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.