How much rates vary
Facilitymedian $7,413 · 10th to 90th $4,169 to $14,125Professionalmedian $2,951 · 10th to 90th $2,630 to $5,248
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 $2,884.03 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,981.07 | $3,981.07 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,888.44 Median $7,585.78 Typical High $14,125.38 | Facility | None | $5,888.44 | $7,585.78 | $14,125.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,235.94 | Professional | None | $2,951.21 | $2,951.21 | $3,235.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | RR · Rental | $295.12 | $295.12 | $323.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,238.72 Median $2,238.72 Typical High $2,454.71 | Professional | UE · Used equipment | $2,238.72 | $2,238.72 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $4,365.16 | Facility | None | $3,548.13 | $3,548.13 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $3,548.13 | Professional | None | $2,630.27 | $2,630.27 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,344.23 Median $5,248.07 Typical High $6,760.83 | Professional | None | $2,344.23 | $5,248.07 | $6,760.83 |
Martin's Point Setting Professional Modifier None Typical Low $2,884.03 Median $3,981.07 Typical High $3,981.07 | Professional | None | $2,884.03 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $4,365.16 | Facility | None | $3,235.94 | $3,235.94 | $4,365.16 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $8,128.31 | Professional | None | $2,344.23 | $2,951.21 | $8,128.31 |
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 $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,445.44 | $1,995.26 | $1,995.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $575.44 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $436.52 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $288.40 | $398.11 | $398.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,995.26 Typical High $1,995.26 | Professional | 52 · Reduced service | $1,445.44 | $1,995.26 | $1,995.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $575.44 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $436.52 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $398.11 Typical High $398.11 | Professional | 56 · Pre-op care only | $288.40 | $398.11 | $398.11 |
Where Maine sits
The same service costs 4.3 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· 28th of 51
$3,236
HI $11,220PA $2,630
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.