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 $630.96 Median $660.69 Typical High $660.69 | Professional | None | $630.96 | $660.69 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $2,570.40 | Facility | None | $1,071.52 | $1,348.96 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $676.08 | Professional | None | $562.34 | $660.69 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | RR · Rental | $66.07 | $66.07 | $72.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $489.78 Median $489.78 Typical High $549.54 | Professional | UE · Used equipment | $489.78 | $489.78 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $676.08 | Facility | None | $616.60 | $616.60 | $676.08 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $416.87 Median $933.25 Typical High $1,230.27 | Professional | None | $416.87 | $933.25 | $1,230.27 |
Martin's Point Setting Professional Modifier None Typical Low $630.96 Median $660.69 Typical High $660.69 | Professional | None | $630.96 | $660.69 | $660.69 |
United Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $1,479.11 | Professional | None | $416.87 | $537.03 | $1,479.11 |
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 $316.23 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $316.23 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $316.23 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $125.89 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $93.33 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $63.10 | $66.07 | $66.07 |
Where Maine sits
The same service costs 2.6 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· 28th of 51
$661
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.