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 $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $158.49 Typical High $295.12 | Facility | None | $123.03 | $158.49 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.61 Median $6.61 Typical High $7.24 | Professional | RR · Rental | $6.61 | $6.61 | $7.24 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | UE · Used equipment | $50.12 | $50.12 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $75.86 | Facility | None | $70.79 | $70.79 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $70.79 | Professional | None | $51.29 | $51.29 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $109.65 Typical High $141.25 | Professional | None | $48.98 | $109.65 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $75.86 | Professional | None | $72.44 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $173.78 | Professional | None | $48.98 | $61.66 | $173.78 |
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 $36.31 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $7.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $36.31 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $14.45 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $11.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.24 | $7.59 | $7.59 |
Where Maine sits
The same service costs 2.6 times more in Hawaii 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· 35th of 51
$66.07
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.