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 $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $229.09 | Facility | None | $95.50 | $120.23 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $56.23 | Professional | None | $44.67 | $52.48 | $56.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.75 | Professional | RR · Rental | $5.25 | $5.25 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | UE · Used equipment | $39.81 | $39.81 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Facility | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $37.15 Median $83.18 Typical High $109.65 | Professional | None | $37.15 | $83.18 | $109.65 |
Martin's Point Setting Professional Modifier None Typical Low $52.48 Median $57.54 Typical High $57.54 | Professional | None | $52.48 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $37.15 Median $47.86 Typical High $131.83 | Professional | None | $37.15 | $47.86 | $131.83 |
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 $27.54 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | 52 · Reduced service | $27.54 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.75 Typical High $11.75 | Professional | 53 · Discontinued | $11.22 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.71 Typical High $8.71 | Professional | 55 · Aftercare only | $8.32 | $8.71 | $8.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 56 · Pre-op care only | $5.50 | $5.75 | $5.75 |
Where Maine sits
The same service costs 2.0 times more in Hawaii than in West Virginia. 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· 31st of 51
$53.70
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.