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 $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,737.80 | Facility | None | $707.95 | $912.01 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | None | $398.11 | $398.11 | $436.52 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $39.81 Median $39.81 Typical High $43.65 | Professional | RR · Rental | $39.81 | $39.81 | $43.65 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | UE · Used equipment | $295.12 | $295.12 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $524.81 | Facility | None | $489.78 | $489.78 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $489.78 | Professional | None | $354.81 | $354.81 | $489.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $281.84 Median $630.96 Typical High $831.76 | Professional | None | $281.84 | $630.96 | $831.76 |
Martin's Point Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | None | $389.05 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $323.59 | Facility | None | $165.96 | $165.96 | $323.59 |
United Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $1,000.00 | Professional | None | $281.84 | $354.81 | $1,000.00 |
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 $204.17 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $48.98 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $204.17 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $97.72 Typical High $97.72 | Professional | 53 · Discontinued | $83.18 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $61.66 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $48.98 |
Where Maine sits
The same service costs 2.4 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· 29th of 51
$427
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.