How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,585 to $4,365Professionalmedian $1,148 · 10th to 90th $871 to $1,585
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 $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,819.70 Median $2,290.87 Typical High $4,365.16 | Facility | None | $1,819.70 | $2,290.87 | $4,365.16 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | RR · Rental | $112.20 | $112.20 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | UE · Used equipment | $831.76 | $831.76 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,288.25 | $1,584.89 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,148.15 Median $1,148.15 Typical High $1,584.89 | Professional | None | $1,148.15 | $1,148.15 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $758.58 Median $1,584.89 Typical High $2,089.30 | Professional | None | $758.58 | $1,584.89 | $2,089.30 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,096.48 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,258.93 | Facility | None | $1,202.26 | $1,202.26 | $1,258.93 |
United Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $2,511.89 | Professional | None | $707.95 | $912.01 | $2,511.89 |
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 $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $616.60 Typical High $616.60 | Professional | 52 · Reduced service | $549.54 | $616.60 | $616.60 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $245.47 Typical High $245.47 | Professional | 53 · Discontinued | $218.78 | $245.47 | $245.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $186.21 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | 56 · Pre-op care only | $109.65 | $123.03 | $123.03 |
Where Maine sits
The same service costs 2.8 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· 31st of 51
$1,202
HI $2,692DC $977
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.