How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,820 to $6,166Professionalmedian $1,202 · 10th to 90th $891 to $2,239
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 $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,235.94 Typical High $6,165.95 | Facility | None | $2,570.40 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,288.25 | Professional | None | $1,174.90 | $1,174.90 | $1,288.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | RR · Rental | $117.49 | $117.49 | $128.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $870.96 Median $870.96 Typical High $954.99 | Professional | UE · Used equipment | $870.96 | $870.96 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,905.46 | Facility | None | $1,230.27 | $1,230.27 | $1,905.46 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,951.21 | Professional | None | $1,000.00 | $2,238.72 | $2,951.21 |
Martin's Point Setting Professional Modifier None Typical Low $1,174.90 Median $1,737.80 Typical High $1,737.80 | Professional | None | $1,174.90 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,202.26 | Facility | None | $1,071.52 | $1,071.52 | $1,202.26 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $3,548.13 | Professional | None | $912.01 | $1,288.25 | $3,548.13 |
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 $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $245.47 | $346.74 | $346.74 |
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 $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $245.47 | $346.74 | $346.74 |
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 3.1 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· 30th of 51
$1,230
HI $2,754DE $891
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.