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 $48.98 Median $54.95 Typical High $54.95 | Professional | None | $48.98 | $54.95 | $54.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $89.13 Median $114.82 Typical High $213.80 | Facility | None | $89.13 | $114.82 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | None | $47.86 | $47.86 | $52.48 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | RR · Rental | $4.79 | $4.79 | $5.25 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | UE · Used equipment | $36.31 | $36.31 | $39.81 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $61.66 | Facility | None | $57.54 | $57.54 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $57.54 | Professional | None | $41.69 | $41.69 | $57.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $79.43 Typical High $102.33 | Professional | None | $34.67 | $79.43 | $102.33 |
Martin's Point Setting Professional Modifier None Typical Low $48.98 Median $54.95 Typical High $54.95 | Professional | None | $48.98 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $34.67 Median $44.67 Typical High $123.03 | Professional | None | $34.67 | $44.67 | $123.03 |
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 $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $5.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $26.30 Median $27.54 Typical High $27.54 | Professional | 52 · Reduced service | $26.30 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 53 · Discontinued | $10.47 | $10.96 | $10.96 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $8.13 Typical High $8.13 | Professional | 55 · Aftercare only | $7.76 | $8.13 | $8.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $5.50 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.25 | $5.50 | $5.50 |
Where Maine sits
The same service costs 2.3 times more in Montana than in Florida. 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· 37th of 51
$47.86
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.