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 $234.42 Median $288.40 Typical High $288.40 | Professional | None | $234.42 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $1,148.15 | Facility | None | $467.74 | $602.56 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $251.19 Typical High $269.15 | Professional | None | $245.47 | $251.19 | $269.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | RR · Rental | $24.55 | $24.55 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | UE · Used equipment | $186.21 | $186.21 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $354.81 | Facility | None | $263.03 | $263.03 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $263.03 | Professional | None | $194.98 | $194.98 | $263.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $186.21 Median $416.87 Typical High $549.54 | Professional | None | $186.21 | $416.87 | $549.54 |
Martin's Point Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | None | $245.47 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $275.42 | Facility | None | $213.80 | $213.80 | $275.42 |
United Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $660.69 | Professional | None | $186.21 | $239.88 | $660.69 |
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 $123.03 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $48.98 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $24.55 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 52 · Reduced service | $123.03 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $57.54 Typical High $57.54 | Professional | 53 · Discontinued | $48.98 | $57.54 | $57.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 55 · Aftercare only | $37.15 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.84 Typical High $28.84 | Professional | 56 · Pre-op care only | $24.55 | $28.84 | $28.84 |
Where Maine sits
The same service costs 4.7 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· 35th of 51
$251
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.