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 $27.54 Median $28.84 Typical High $28.84 | Professional | None | $27.54 | $28.84 | $28.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $60.26 Typical High $114.82 | Facility | None | $46.77 | $60.26 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | None | $26.92 | $26.92 | $29.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | RR · Rental | $2.69 | $2.69 | $2.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | UE · Used equipment | $19.95 | $19.95 | $21.88 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.62 Median $41.69 Typical High $54.95 | Professional | None | $18.62 | $41.69 | $54.95 |
Martin's Point Setting Professional Modifier None Typical Low $27.54 Median $28.84 Typical High $28.84 | Professional | None | $27.54 | $28.84 | $28.84 |
United Setting Professional Modifier None Typical Low $18.62 Median $23.99 Typical High $66.07 | Professional | None | $18.62 | $23.99 | $66.07 |
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 $13.80 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.17 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $2.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 52 · Reduced service | $13.80 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.75 Typical High $5.75 | Professional | 53 · Discontinued | $5.50 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $4.37 Typical High $4.37 | Professional | 55 · Aftercare only | $4.17 | $4.37 | $4.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $2.88 Typical High $2.88 | Professional | 56 · Pre-op care only | $2.75 | $2.88 | $2.88 |
Where Maine sits
The same service costs 2.6 times more in Montana 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· 32nd of 51
$26.92
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.