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 Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $77.62 | Professional | None | $37.15 | $53.70 | $77.62 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $208.93 | Facility | None | $87.10 | $112.20 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | None | $39.81 | $39.81 | $43.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.98 Median $3.98 Typical High $4.37 | Professional | RR · Rental | $3.98 | $3.98 | $4.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | UE · Used equipment | $30.20 | $30.20 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $64.57 | Facility | None | $45.71 | $45.71 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $45.71 | Professional | None | $33.11 | $33.11 | $45.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $77.62 Typical High $100.00 | Professional | None | $34.67 | $77.62 | $100.00 |
Martin's Point Setting Professional Modifier None Typical Low $38.90 Median $53.70 Typical High $77.62 | Professional | None | $38.90 | $53.70 | $77.62 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Facility | None | $43.65 | $43.65 | $52.48 |
United Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $123.03 | Professional | None | $33.11 | $43.65 | $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 $19.95 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $19.95 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $5.89 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $5.37 | $5.37 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $19.95 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $19.95 | $26.92 | $26.92 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $7.94 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $5.89 | $7.94 | $7.94 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.98 | $5.37 | $5.37 |
Where Maine sits
The same service costs 3.8 times more in Hawaii 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· 32nd of 51
$43.65
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.