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 $61.66 Median $72.44 Typical High $72.44 | Professional | None | $61.66 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $117.49 Median $151.36 Typical High $281.84 | Facility | None | $117.49 | $151.36 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | None | $61.66 | $61.66 | $67.61 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.17 Median $6.17 Typical High $6.76 | Professional | RR · Rental | $6.17 | $6.17 | $6.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $46.77 Median $46.77 Typical High $51.29 | Professional | UE · Used equipment | $46.77 | $46.77 | $51.29 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $87.10 | Facility | None | $66.07 | $66.07 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $66.07 | Professional | None | $48.98 | $48.98 | $66.07 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $46.77 Median $104.71 Typical High $134.90 | Professional | None | $46.77 | $104.71 | $134.90 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | None | $61.66 | $72.44 | $72.44 |
United Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $61.66 | Facility | None | $46.77 | $46.77 | $61.66 |
United Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $162.18 | Professional | None | $46.77 | $58.88 | $162.18 |
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 $30.90 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $7.24 | $7.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $30.90 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $12.30 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $9.12 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.17 | $7.24 | $7.24 |
Where Maine sits
The same service costs 2.7 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· 34th of 51
$61.66
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.