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 $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $2,511.89 | Facility | None | $1,047.13 | $1,348.96 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Professional | None | $478.63 | $478.63 | $524.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $47.86 Median $47.86 Typical High $52.48 | Professional | RR · Rental | $47.86 | $47.86 | $52.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | UE · Used equipment | $363.08 | $363.08 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $776.25 | Facility | None | $489.78 | $489.78 | $776.25 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $489.78 | Professional | None | $363.08 | $363.08 | $489.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $933.25 Typical High $1,202.26 | Professional | None | $407.38 | $933.25 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $524.81 | Facility | None | $478.63 | $478.63 | $524.81 |
United Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $1,445.44 | Professional | None | $371.54 | $524.81 | $1,445.44 |
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 $239.88 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $95.50 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $47.86 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $239.88 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $128.82 Typical High $128.82 | Professional | 53 · Discontinued | $95.50 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $70.79 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $64.57 Typical High $64.57 | Professional | 56 · Pre-op care only | $47.86 | $64.57 | $64.57 |
Where Maine sits
The same service costs 3.2 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· 26th of 51
$525
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.