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 $14.79 Median $16.98 Typical High $16.98 | Professional | None | $14.79 | $16.98 | $16.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $58.88 | Professional | None | $54.95 | $54.95 | $58.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | RR · Rental | $5.50 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | UE · Used equipment | $40.74 | $40.74 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $30.90 | Facility | None | $28.18 | $28.18 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $28.18 | Professional | None | $20.42 | $20.42 | $28.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $11.75 Median $30.90 Typical High $52.48 | Professional | None | $11.75 | $30.90 | $52.48 |
Martin's Point Setting Professional Modifier None Typical Low $14.79 Median $16.98 Typical High $16.98 | Professional | None | $14.79 | $16.98 | $16.98 |
United Setting Professional Modifier None Typical Low $9.33 Median $14.13 Typical High $37.15 | Professional | None | $9.33 | $14.13 | $37.15 |
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 $7.76 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.09 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.29 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.55 | $1.74 | $1.74 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $7.76 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $7.76 | $8.51 | $8.51 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.09 | $3.47 | $3.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.29 | $2.57 | $2.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.55 | $1.74 | $1.74 |
Where Maine sits
The same service costs 8.7 times more in Hawaii 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· 9th of 51
$30.90
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.