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 $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $489.78 | Facility | None | $204.17 | $263.03 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $120.23 | Professional | None | $109.65 | $112.20 | $120.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.96 Median $10.96 Typical High $12.02 | Professional | RR · Rental | $10.96 | $10.96 | $12.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $81.28 Median $81.28 Typical High $89.13 | Professional | UE · Used equipment | $81.28 | $81.28 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $151.36 | Facility | None | $112.20 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $112.20 | Professional | None | $83.18 | $83.18 | $112.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $181.97 Typical High $234.42 | Professional | None | $81.28 | $181.97 | $234.42 |
Martin's Point Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $125.89 | Professional | None | $107.15 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
United Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $288.40 | Professional | None | $81.28 | $102.33 | $288.40 |
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 $56.23 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $56.23 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $22.39 | $25.12 | $25.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $16.98 | $18.62 | $18.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $11.22 | $12.59 | $12.59 |
Where Maine sits
The same service costs 2.3 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
$112
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.