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 $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $269.15 | Facility | None | $112.20 | $144.54 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $67.61 Typical High $72.44 | Professional | None | $66.07 | $67.61 | $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 $77.62 | Facility | None | $70.79 | $70.79 | $77.62 |
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 $44.67 Median $100.00 Typical High $128.82 | Professional | None | $44.67 | $100.00 | $128.82 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | None | $66.07 | $69.18 | $69.18 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
United Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $154.88 | Professional | None | $44.67 | $56.23 | $154.88 |
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 $33.11 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.18 | $13.80 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.61 | $6.92 | $6.92 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $34.67 | $34.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $13.80 | Professional | 53 · Discontinued | $13.80 | $13.80 | $13.80 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $10.23 Typical High $10.23 | Professional | 55 · Aftercare only | $9.77 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.92 Typical High $6.92 | Professional | 56 · Pre-op care only | $6.61 | $6.92 | $6.92 |
Where Maine sits
The same service costs 2.4 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· 28th of 51
$67.61
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.