How much rates vary
Facilitymedian $6,310 · 10th to 90th $3,631 to $12,023Professionalmedian $2,818 · 10th to 90th $2,399 to $4,467
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 $2,754.23 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,754.23 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,456.54 Typical High $12,022.64 | Facility | None | $5,011.87 | $6,456.54 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,090.30 | Professional | None | $2,818.38 | $2,818.38 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | RR · Rental | $281.84 | $281.84 | $309.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,630.78 Typical High $3,715.35 | Facility | None | $3,548.13 | $3,630.78 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,630.78 | Professional | None | $2,691.53 | $2,691.53 | $3,630.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,995.26 Median $4,466.84 Typical High $5,754.40 | Professional | None | $1,995.26 | $4,466.84 | $5,754.40 |
Martin's Point Setting Professional Modifier None Typical Low $2,754.23 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,754.23 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $3,090.30 Median $3,090.30 Typical High $3,311.31 | Facility | None | $3,090.30 | $3,090.30 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $2,511.89 Typical High $7,079.46 | Professional | None | $1,995.26 | $2,511.89 | $7,079.46 |
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 $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,380.38 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $416.87 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $275.42 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,380.38 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,380.38 | $1,698.24 | $1,698.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $549.54 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $416.87 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $275.42 | $338.84 | $338.84 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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· 27th of 51
$3,090
HI $7,413PA $2,455
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.