How much rates vary
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 $194.98 Median $302.00 Typical High $302.00 | Professional | None | $194.98 | $302.00 | $302.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $575.44 Typical High $1,071.52 | Facility | None | $446.68 | $575.44 | $1,071.52 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $218.78 Typical High $234.42 | Professional | None | $213.80 | $218.78 | $234.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.38 Median $21.38 Typical High $23.44 | Professional | RR · Rental | $21.38 | $21.38 | $23.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $162.18 Median $162.18 Typical High $177.83 | Professional | UE · Used equipment | $162.18 | $162.18 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $269.15 Typical High $331.13 | Facility | None | $269.15 | $269.15 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $177.83 Median $398.11 Typical High $512.86 | Professional | None | $177.83 | $398.11 | $512.86 |
Martin's Point Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $302.00 | Professional | None | $194.98 | $302.00 | $302.00 |
United Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $173.78 | Facility | None | $158.49 | $158.49 | $173.78 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $616.60 | Professional | None | $169.82 | $223.87 | $616.60 |
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 $102.33 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $151.36 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $151.36 Typical High $151.36 | Professional | 52 · Reduced service | $102.33 | $151.36 | $151.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $45.71 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $30.20 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $30.20 |
Where Maine sits
The same service costs 2.0 times more in Wisconsin than in Colorado. 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· 29th of 51
$224
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.