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 $85.11 Median $95.50 Typical High $95.50 | Professional | None | $85.11 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | RR · Rental | $15.85 | $15.85 | $17.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | UE · Used equipment | $117.49 | $117.49 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $60.26 | Facility | None | $56.23 | $56.23 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $56.23 | Professional | None | $41.69 | $41.69 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $64.57 Median $173.78 Typical High $218.78 | Professional | None | $64.57 | $173.78 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $95.50 | Professional | None | $85.11 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $208.93 | Professional | None | $52.48 | $77.62 | $208.93 |
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 $42.66 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $9.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $42.66 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $42.66 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $19.05 | $19.05 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $12.88 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.51 | $9.55 | $9.55 |
Where Maine sits
The same service costs 4.9 times more in North Dakota than in Delaware. 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· 8th of 51
$145
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.