How much rates vary
Facilitymedian $3,631 · 10th to 90th $2,089 to $7,079Professionalmedian $1,820 · 10th to 90th $1,288 to $2,570
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 $1,698.24 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,995.26 | $1,995.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,884.03 Median $3,715.35 Typical High $7,079.46 | Facility | None | $2,884.03 | $3,715.35 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,548.82 Median $1,819.70 Typical High $1,995.26 | Professional | None | $1,548.82 | $1,819.70 | $1,995.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $181.97 Median $181.97 Typical High $199.53 | Professional | RR · Rental | $181.97 | $181.97 | $199.53 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,348.96 Median $1,348.96 Typical High $1,479.11 | Professional | UE · Used equipment | $1,348.96 | $1,348.96 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Facility | None | $1,778.28 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,174.90 Median $2,570.40 Typical High $3,388.44 | Professional | None | $1,174.90 | $2,570.40 | $3,388.44 |
Martin's Point Setting Professional Modifier None Typical Low $1,698.24 Median $1,995.26 Typical High $1,995.26 | Professional | None | $1,698.24 | $1,995.26 | $1,995.26 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,862.09 | Facility | None | $1,230.27 | $1,230.27 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $4,073.80 | Professional | None | $1,148.15 | $1,479.11 | $4,073.80 |
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 $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $398.11 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $870.96 Median $1,000.00 Typical High $1,000.00 | Professional | 52 · Reduced service | $870.96 | $1,000.00 | $1,000.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $398.11 Typical High $398.11 | Professional | 53 · Discontinued | $346.74 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $257.04 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $199.53 Typical High $199.53 | Professional | 56 · Pre-op care only | $173.78 | $199.53 | $199.53 |
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· 24th of 51
$1,862
HI $4,169DE $1,288
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.