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 $36.31 Median $39.81 Typical High $39.81 | Professional | None | $36.31 | $39.81 | $39.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Professional | None | $50.12 | $50.12 | $53.70 |
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 $37.15 Median $37.15 Typical High $40.74 | Professional | UE · Used equipment | $37.15 | $37.15 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $53.70 | Facility | None | $50.12 | $50.12 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $50.12 | Professional | None | $36.31 | $36.31 | $50.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $27.54 Median $72.44 Typical High $104.71 | Professional | None | $27.54 | $72.44 | $104.71 |
Martin's Point Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $39.81 | Professional | None | $36.31 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $87.10 | Professional | None | $21.88 | $33.11 | $87.10 |
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 $18.20 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.37 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.63 | $3.98 | $3.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $19.95 Typical High $19.95 | Professional | 52 · Reduced service | $18.20 | $19.95 | $19.95 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.94 Typical High $7.94 | Professional | 53 · Discontinued | $7.24 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.03 Typical High $6.03 | Professional | 55 · Aftercare only | $5.37 | $6.03 | $6.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.98 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.63 | $3.98 | $3.98 |
Where Maine sits
The same service costs 4.1 times more in Kansas than in Colorado. 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· 10th of 51
$50.12
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.