How much rates vary
Facilitymedian $3,090 · 10th to 90th $1,738 to $5,888Professionalmedian $1,318 · 10th to 90th $1,175 to $2,188
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 $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,454.71 Median $3,162.28 Typical High $5,888.44 | Facility | None | $2,454.71 | $3,162.28 | $5,888.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | None | $1,318.26 | $1,318.26 | $1,445.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | RR · Rental | $131.83 | $131.83 | $144.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | UE · Used equipment | $977.24 | $977.24 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,819.70 | Facility | None | $1,584.89 | $1,584.89 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $977.24 Median $2,187.76 Typical High $2,818.38 | Professional | None | $977.24 | $2,187.76 | $2,818.38 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,230.27 | $1,659.59 | $1,659.59 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,258.93 | $1,258.93 | $1,445.44 |
United Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $3,467.37 | Professional | None | $977.24 | $1,230.27 | $3,467.37 |
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 $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $831.76 Typical High $831.76 | Professional | 52 · Reduced service | $645.65 | $831.76 | $831.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $331.13 Typical High $331.13 | Professional | 53 · Discontinued | $263.03 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $251.19 Typical High $251.19 | Professional | 55 · Aftercare only | $194.98 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $165.96 Typical High $165.96 | Professional | 56 · Pre-op care only | $131.83 | $165.96 | $165.96 |
Where Maine sits
The same service costs 2.7 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· 32nd of 51
$1,349
HI $3,162DE $1,175
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.