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 $60.26 Median $77.62 Typical High $158.49 | Professional | None | $60.26 | $77.62 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $309.03 | Facility | None | $125.89 | $162.18 | $309.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $61.66 | Professional | None | $56.23 | $57.54 | $61.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.62 Median $5.62 Typical High $6.17 | Professional | RR · Rental | $5.62 | $5.62 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | UE · Used equipment | $42.66 | $42.66 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Facility | None | $61.66 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $61.66 | Professional | None | $44.67 | $44.67 | $61.66 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $50.12 Median $112.20 Typical High $147.91 | Professional | None | $50.12 | $112.20 | $147.91 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $77.62 Typical High $95.50 | Professional | None | $60.26 | $77.62 | $95.50 |
United Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $177.83 | Professional | None | $47.86 | $63.10 | $177.83 |
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 $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $12.02 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $7.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | 52 · Reduced service | $30.20 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $15.49 Typical High $15.49 | Professional | 53 · Discontinued | $12.02 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $11.75 Typical High $11.75 | Professional | 55 · Aftercare only | $8.91 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.03 | $7.76 | $7.76 |
Where Maine sits
The same service costs 2.1 times more in Wisconsin than in New Jersey. 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· 33rd of 51
$60.26
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.