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 $199.53 Median $275.42 Typical High $275.42 | Professional | None | $199.53 | $275.42 | $275.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $1,096.48 | Facility | None | $446.68 | $575.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $213.80 Typical High $229.09 | Professional | None | $204.17 | $213.80 | $229.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | RR · Rental | $20.42 | $20.42 | $22.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $154.88 Median $154.88 Typical High $169.82 | Professional | UE · Used equipment | $154.88 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $331.13 | Facility | None | $229.09 | $229.09 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $524.81 | Professional | None | $177.83 | $398.11 | $524.81 |
Martin's Point Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | None | $204.17 | $275.42 | $275.42 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $251.19 | Facility | None | $229.09 | $229.09 | $251.19 |
United Setting Professional Modifier None Typical Low $165.96 Median $229.09 Typical High $630.96 | Professional | None | $165.96 | $229.09 | $630.96 |
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 $102.33 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $138.04 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $138.04 | $138.04 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $30.90 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $27.54 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $27.54 | $27.54 |
Where Maine sits
The same service costs 3.5 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· 36th of 51
$214
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.