How much rates vary
Facilitymedian $6,166 · 10th to 90th $3,548 to $12,023Professionalmedian $2,455 · 10th to 90th $1,995 to $4,365
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 $2,398.83 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,388.44 | $3,388.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,011.87 Median $6,309.57 Typical High $12,022.64 | Facility | None | $5,011.87 | $6,309.57 | $12,022.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,041.74 Median $2,398.83 Typical High $2,630.27 | Professional | None | $2,041.74 | $2,398.83 | $2,630.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | RR · Rental | $239.88 | $239.88 | $263.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,778.28 Median $1,778.28 Typical High $1,995.26 | Professional | UE · Used equipment | $1,778.28 | $1,778.28 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,715.35 | Facility | None | $2,754.23 | $2,754.23 | $3,715.35 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,754.23 | Professional | None | $1,995.26 | $1,995.26 | $2,754.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,949.84 Median $4,365.16 Typical High $5,754.40 | Professional | None | $1,949.84 | $4,365.16 | $5,754.40 |
Martin's Point Setting Professional Modifier None Typical Low $2,398.83 Median $3,388.44 Typical High $3,388.44 | Professional | None | $2,398.83 | $3,388.44 | $3,388.44 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,398.83 | Facility | None | $2,187.76 | $2,187.76 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $6,918.31 | Professional | None | $1,862.09 | $2,511.89 | $6,918.31 |
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 $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,202.26 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $478.63 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $354.81 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $239.88 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,698.24 Typical High $1,698.24 | Professional | 52 · Reduced service | $1,202.26 | $1,698.24 | $1,698.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $478.63 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $512.86 Typical High $512.86 | Professional | 55 · Aftercare only | $354.81 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $338.84 Typical High $338.84 | Professional | 56 · Pre-op care only | $239.88 | $338.84 | $338.84 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in West Virginia. 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· 33rd of 51
$2,455
HI $5,129WV $1,995
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.