How much rates vary
Facilitymedian $2,188 · 10th to 90th $1,230 to $4,169Professionalmedian $1,445 · 10th to 90th $708 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 $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | None | $977.24 | $1,174.90 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $4,168.69 | Facility | None | $1,737.80 | $2,238.72 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,445.44 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | RR · Rental | $144.54 | $144.54 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $954.99 Typical High $1,288.25 | Facility | None | $954.99 | $954.99 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $691.83 Median $1,548.82 Typical High $1,995.26 | Professional | None | $691.83 | $1,548.82 | $1,995.26 |
Martin's Point Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,174.90 | Professional | None | $977.24 | $1,174.90 | $1,174.90 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $1,023.29 | Facility | None | $173.78 | $173.78 | $1,023.29 |
United Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $2,454.71 | Professional | None | $691.83 | $870.96 | $2,454.71 |
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 $489.78 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $489.78 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $194.98 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $144.54 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $117.49 |
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· 13th of 51
$1,445
HI $2,239DE $708
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.