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 $416.87 Median $436.52 Typical High $436.52 | Professional | None | $416.87 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,737.80 | Facility | None | $707.95 | $912.01 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | None | $467.74 | $467.74 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | RR · Rental | $46.77 | $46.77 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | UE · Used equipment | $346.74 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $446.68 Typical High $524.81 | Facility | None | $446.68 | $446.68 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $302.00 Median $630.96 Typical High $831.76 | Professional | None | $302.00 | $630.96 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $436.52 | Professional | None | $407.38 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $630.96 | Facility | None | $478.63 | $478.63 | $630.96 |
United Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $1,000.00 | Professional | None | $281.84 | $363.08 | $1,000.00 |
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 $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $218.78 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $87.10 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $43.65 | $43.65 | $43.65 |
Where Maine sits
The same service costs 4.6 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· 29th of 51
$468
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.