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 $28.84 Median $36.31 Typical High $36.31 | Professional | None | $28.84 | $36.31 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $58.88 Median $75.86 Typical High $144.54 | Facility | None | $58.88 | $75.86 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $34.67 Typical High $36.31 | Professional | None | $33.11 | $34.67 | $36.31 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.31 Median $3.31 Typical High $3.63 | Professional | RR · Rental | $3.31 | $3.31 | $3.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | UE · Used equipment | $25.12 | $25.12 | $27.54 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Facility | None | $33.88 | $33.88 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.44 Median $52.48 Typical High $69.18 | Professional | None | $23.44 | $52.48 | $69.18 |
Martin's Point Setting Professional Modifier None Typical Low $33.11 Median $36.31 Typical High $36.31 | Professional | None | $33.11 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $23.44 Median $30.20 Typical High $83.18 | Professional | None | $23.44 | $30.20 | $83.18 |
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 $17.38 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $17.38 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.92 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.47 | $3.63 | $3.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $17.38 | $18.20 | $18.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $6.92 | $7.24 | $7.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 55 · Aftercare only | $5.25 | $5.50 | $5.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.47 | $3.63 | $3.63 |
Where Maine sits
The same service costs 2.8 times more in Montana than in Kansas. 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· 29th of 51
$34.67
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.