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 $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $1,318.26 | Facility | None | $549.54 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.20 Median $30.20 Typical High $33.88 | Professional | RR · Rental | $30.20 | $30.20 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | UE · Used equipment | $229.09 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Facility | None | $346.74 | $346.74 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $346.74 | Professional | None | $251.19 | $251.19 | $346.74 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $630.96 | Professional | None | $213.80 | $478.63 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | None | $316.23 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $251.19 | Facility | None | $173.78 | $173.78 | $251.19 |
United Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $758.58 | Professional | None | $213.80 | $275.42 | $758.58 |
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 $158.49 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $63.10 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $47.86 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $37.15 | $37.15 |
Where Maine sits
The same service costs 2.9 times more in Iowa than in Kansas. 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· 30th of 51
$339
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.