How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $23.99 Median $27.54 Typical High $27.54 | Professional | None | $23.99 | $27.54 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $50.12 Typical High $54.95 | Professional | None | $38.02 | $50.12 | $54.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.01 Median $5.01 Typical High $5.50 | Professional | RR · Rental | $5.01 | $5.01 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | UE · Used equipment | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $32.36 | Facility | None | $30.20 | $30.20 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $30.20 | Professional | None | $21.88 | $21.88 | $30.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.62 Median $50.12 Typical High $70.79 | Professional | None | $18.62 | $50.12 | $70.79 |
Martin's Point Setting Professional Modifier None Typical Low $23.99 Median $27.54 Typical High $27.54 | Professional | None | $23.99 | $27.54 | $27.54 |
United Setting Professional Modifier None Typical Low $15.14 Median $22.39 Typical High $60.26 | Professional | None | $15.14 | $22.39 | $60.26 |
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 $12.30 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $12.30 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.90 | $5.50 | $5.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.45 | $2.75 | $2.75 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $13.80 Typical High $13.80 | Professional | 52 · Reduced service | $12.30 | $13.80 | $13.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $5.50 Typical High $5.50 | Professional | 53 · Discontinued | $4.90 | $5.50 | $5.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $4.07 Typical High $4.07 | Professional | 55 · Aftercare only | $3.72 | $4.07 | $4.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.75 Typical High $2.75 | Professional | 56 · Pre-op care only | $2.45 | $2.75 | $2.75 |
Where Maine sits
The same service costs 6.5 times more in Kansas than in Hawaii. 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
$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.