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 $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $3,801.89 | Facility | None | $1,548.82 | $1,995.26 | $3,801.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $741.31 Typical High $776.25 | Professional | None | $707.95 | $741.31 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $70.79 Median $70.79 Typical High $77.62 | Professional | RR · Rental | $70.79 | $70.79 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | UE · Used equipment | $537.03 | $537.03 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $741.31 Typical High $1,148.15 | Facility | None | $741.31 | $741.31 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $741.31 | Professional | None | $537.03 | $537.03 | $741.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $616.60 Median $1,380.38 Typical High $1,819.70 | Professional | None | $616.60 | $1,380.38 | $1,819.70 |
Martin's Point Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $954.99 | Professional | None | $707.95 | $954.99 | $954.99 |
United Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $912.01 | Facility | None | $776.25 | $776.25 | $912.01 |
United Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $2,187.76 | Professional | None | $549.54 | $776.25 | $2,187.76 |
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 $363.08 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $478.63 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $95.50 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $95.50 | $95.50 |
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· 35th of 51
$741
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.