How much rates vary
Facilitymedian $4,169 · 10th to 90th $2,344 to $7,943Professionalmedian $1,738 · 10th to 90th $1,585 to $2,884
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 $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $4,168.69 Typical High $7,943.28 | Facility | None | $3,311.31 | $4,168.69 | $7,943.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,737.80 | $1,737.80 | $1,905.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | RR · Rental | $173.78 | $173.78 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | UE · Used equipment | $1,318.26 | $1,318.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,454.71 | Facility | None | $2,290.87 | $2,290.87 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,659.59 | $1,659.59 | $2,290.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,288.25 Median $2,884.03 Typical High $3,801.89 | Professional | None | $1,288.25 | $2,884.03 | $3,801.89 |
Martin's Point Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $2,238.72 | Professional | None | $1,737.80 | $2,238.72 | $2,238.72 |
United Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $1,905.46 | Facility | None | $1,778.28 | $1,778.28 | $1,905.46 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $4,570.88 | Professional | None | $1,288.25 | $1,659.59 | $4,570.88 |
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 $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $371.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $912.01 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $371.54 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 55 · Aftercare only | $275.42 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $223.87 | $223.87 |
Where Maine sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 33rd of 51
$1,820
HI $4,365PA $1,549
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.