How much rates vary
Facilitymedian $8,913 · 10th to 90th $5,012 to $17,378Professionalmedian $3,631 · 10th to 90th $3,388 to $6,310
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 $3,890.45 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,890.45 | $4,897.79 | $4,897.79 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $9,120.11 Typical High $17,378.01 | Facility | None | $7,079.46 | $9,120.11 | $17,378.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $4,073.80 | Professional | None | $3,630.78 | $3,630.78 | $4,073.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | RR · Rental | $363.08 | $363.08 | $407.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,754.23 Median $2,754.23 Typical High $3,019.95 | Professional | UE · Used equipment | $2,754.23 | $2,754.23 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Facility | None | $4,677.35 | $4,677.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,818.38 Median $6,309.57 Typical High $8,317.64 | Professional | None | $2,818.38 | $6,309.57 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $3,890.45 Median $4,897.79 Typical High $4,897.79 | Professional | None | $3,890.45 | $4,897.79 | $4,897.79 |
United Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,073.80 | $4,897.79 |
United Setting Professional Modifier None Typical Low $2,818.38 Median $3,548.13 Typical High $10,000.00 | Professional | None | $2,818.38 | $3,548.13 | $10,000.00 |
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 $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,905.46 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $776.25 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $389.05 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,905.46 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,905.46 | $2,398.83 | $2,398.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $977.24 Typical High $977.24 | Professional | 53 · Discontinued | $776.25 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $575.44 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | 56 · Pre-op care only | $389.05 | $489.78 | $489.78 |
Where Maine sits
The same service costs 3.9 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· 29th of 51
$4,074
HI $12,882DC $3,311
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.