How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,455 to $8,128Professionalmedian $1,995 · 10th to 90th $1,622 to $2,951
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 $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,995.26 | $2,290.87 | $2,290.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,388.44 Median $4,265.80 Typical High $8,128.31 | Facility | None | $3,388.44 | $4,265.80 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,995.26 | $1,995.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | RR · Rental | $199.53 | $199.53 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,479.11 Median $1,479.11 Typical High $1,621.81 | Professional | UE · Used equipment | $1,479.11 | $1,479.11 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,398.83 | $2,454.71 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,819.70 | $2,454.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,380.38 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,380.38 | $2,951.21 | $3,890.45 |
Martin's Point Setting Professional Modifier None Typical Low $1,995.26 Median $2,290.87 Typical High $2,290.87 | Professional | None | $1,995.26 | $2,290.87 | $2,290.87 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,290.87 | Facility | None | $2,187.76 | $2,187.76 | $2,290.87 |
United Setting Professional Modifier None Typical Low $1,318.26 Median $1,698.24 Typical High $4,677.35 | Professional | None | $1,318.26 | $1,698.24 | $4,677.35 |
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 $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,000.00 | $1,148.15 | $1,148.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $398.11 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $199.53 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,148.15 Typical High $1,148.15 | Professional | 52 · Reduced service | $1,000.00 | $1,148.15 | $1,148.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $457.09 Typical High $457.09 | Professional | 53 · Discontinued | $398.11 | $457.09 | $457.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $346.74 Typical High $346.74 | Professional | 55 · Aftercare only | $302.00 | $346.74 | $346.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $229.09 Typical High $229.09 | Professional | 56 · Pre-op care only | $199.53 | $229.09 | $229.09 |
Where Maine sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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
$2,188
HI $5,623DC $1,778
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.