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 $380.19 Median $426.58 Typical High $426.58 | Professional | None | $380.19 | $426.58 | $426.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $794.33 Typical High $1,513.56 | Facility | None | $630.96 | $794.33 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $407.38 | Professional | None | $371.54 | $371.54 | $407.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | RR · Rental | $37.15 | $37.15 | $40.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $275.42 Median $275.42 Typical High $302.00 | Professional | UE · Used equipment | $275.42 | $275.42 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $467.74 | Facility | None | $426.58 | $426.58 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $251.19 Median $549.54 Typical High $724.44 | Professional | None | $251.19 | $549.54 | $724.44 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $426.58 | Professional | None | $380.19 | $426.58 | $426.58 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $380.19 | Facility | None | $338.84 | $338.84 | $380.19 |
United Setting Professional Modifier None Typical Low $245.47 Median $316.23 Typical High $870.96 | Professional | None | $245.47 | $316.23 | $870.96 |
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 $190.55 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $42.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $213.80 Typical High $213.80 | Professional | 52 · Reduced service | $190.55 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $85.11 Typical High $85.11 | Professional | 53 · Discontinued | $75.86 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $42.66 Typical High $42.66 | Professional | 56 · Pre-op care only | $38.02 | $42.66 | $42.66 |
Where Maine sits
The same service costs 2.7 times more in Hawaii 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· 29th of 51
$407
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.