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 $56.23 Median $70.79 Typical High $144.54 | Professional | None | $56.23 | $70.79 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $147.91 Typical High $281.84 | Facility | None | $114.82 | $147.91 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $63.10 Typical High $67.61 | Professional | None | $61.66 | $63.10 | $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 $45.71 Median $45.71 Typical High $50.12 | Professional | UE · Used equipment | $45.71 | $45.71 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $85.11 | Facility | None | $67.61 | $67.61 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $67.61 | Professional | None | $50.12 | $50.12 | $67.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $45.71 Median $102.33 Typical High $134.90 | Professional | None | $45.71 | $102.33 | $134.90 |
Martin's Point Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $144.54 | Professional | None | $60.26 | $70.79 | $144.54 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $77.62 | Facility | None | $67.61 | $67.61 | $77.62 |
United Setting Professional Modifier None Typical Low $45.71 Median $58.88 Typical High $162.18 | Professional | None | $45.71 | $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 $30.20 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $30.20 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $14.13 | $14.13 |
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 $6.03 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $30.20 | $35.48 | $35.48 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $14.13 | Professional | 53 · Discontinued | $12.02 | $14.13 | $14.13 |
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 $6.03 Median $7.08 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $7.08 |
Where Maine sits
The same service costs 4.1 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· 32nd of 51
$63.10
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.