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 $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $3,467.37 | Facility | None | $1,412.54 | $1,819.70 | $3,467.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $977.24 | Professional | None | $870.96 | $870.96 | $977.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $87.10 Typical High $97.72 | Professional | RR · Rental | $87.10 | $87.10 | $97.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | UE · Used equipment | $660.69 | $660.69 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,071.52 | Facility | None | $912.01 | $912.01 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $1,258.93 Typical High $1,659.59 | Professional | None | $602.56 | $1,258.93 | $1,659.59 |
Martin's Point Setting Professional Modifier None Typical Low $870.96 Median $977.24 Typical High $977.24 | Professional | None | $870.96 | $977.24 | $977.24 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $954.99 | Facility | None | $812.83 | $812.83 | $954.99 |
United Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,995.26 | Professional | None | $562.34 | $724.44 | $1,995.26 |
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 $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $436.52 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $436.52 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $173.78 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $144.54 Typical High $144.54 | Professional | 55 · Aftercare only | $128.82 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $87.10 | $97.72 | $97.72 |
Where Maine sits
The same service costs 3.2 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· 29th of 51
$912
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.