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 $45.71 Median $61.66 Typical High $61.66 | Professional | None | $45.71 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $100.00 Median $128.82 Typical High $245.47 | Facility | None | $100.00 | $128.82 | $245.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $50.12 Typical High $61.66 | Professional | None | $45.71 | $50.12 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.57 Median $4.57 Typical High $5.01 | Professional | RR · Rental | $4.57 | $4.57 | $5.01 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | UE · Used equipment | $33.88 | $33.88 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $74.13 | Facility | None | $54.95 | $54.95 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $54.95 | Professional | None | $39.81 | $39.81 | $54.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $117.49 | Professional | None | $39.81 | $89.13 | $117.49 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $61.66 | Professional | None | $45.71 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Facility | None | $51.29 | $51.29 | $51.29 |
United Setting Professional Modifier None Typical Low $36.31 Median $50.12 Typical High $141.25 | Professional | None | $36.31 | $50.12 | $141.25 |
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 $25.70 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $25.70 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $10.23 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.76 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.13 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $25.70 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $10.23 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.76 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.13 | $6.17 | $6.17 |
Where Maine sits
The same service costs 3.5 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· 18th of 51
$61.66
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.