How much rates vary
Facilitymedian $2,455 · 10th to 90th $1,413 to $4,786Professionalmedian $1,122 · 10th to 90th $933 to $1,738
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 $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,348.96 | $1,348.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,949.84 Median $2,511.89 Typical High $4,786.30 | Facility | None | $1,949.84 | $2,511.89 | $4,786.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | RR · Rental | $112.20 | $112.20 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $831.76 Median $831.76 Typical High $912.01 | Professional | UE · Used equipment | $831.76 | $831.76 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Facility | None | $1,318.26 | $1,318.26 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,318.26 | Professional | None | $954.99 | $954.99 | $1,318.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $776.25 Median $1,737.80 Typical High $2,290.87 | Professional | None | $776.25 | $1,737.80 | $2,290.87 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,096.48 | $1,348.96 | $1,348.96 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $1,000.00 Typical High $1,000.00 | Facility | None | $1,000.00 | $1,000.00 | $1,000.00 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $2,754.23 | Professional | None | $776.25 | $1,000.00 | $2,754.23 |
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 $549.54 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $549.54 Median $676.08 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $676.08 | $676.08 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $134.90 |
Where Maine sits
The same service costs 3.0 times more in Kansas 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
KS $2,818DE $955
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.