How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,820 to $6,310Professionalmedian $1,230 · 10th to 90th $933 to $2,291
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 $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,311.31 Typical High $6,309.57 | Facility | None | $2,570.40 | $3,311.31 | $6,309.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,380.38 | Professional | None | $1,230.27 | $1,230.27 | $1,380.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $123.03 Median $123.03 Typical High $138.04 | Professional | RR · Rental | $123.03 | $123.03 | $138.04 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $933.25 Median $933.25 Typical High $1,023.29 | Professional | UE · Used equipment | $933.25 | $933.25 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,905.46 | Facility | None | $1,258.93 | $1,258.93 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,023.29 | $2,290.87 | $3,019.95 |
Martin's Point Setting Professional Modifier None Typical Low $1,148.15 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,148.15 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,584.89 | Facility | None | $1,348.96 | $1,348.96 | $1,584.89 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,288.25 Typical High $3,630.78 | Professional | None | $1,000.00 | $1,288.25 | $3,630.78 |
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 $616.60 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $245.47 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $123.03 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $616.60 | $870.96 | $870.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $245.47 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $181.97 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $123.03 | $173.78 | $173.78 |
Where Maine sits
The same service costs 3.8 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· 28th of 51
$1,288
HI $3,548DE $933
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.