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 $263.03 Median $363.08 Typical High $363.08 | Professional | None | $263.03 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $1,288.25 | Facility | None | $537.03 | $691.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | None | $263.03 | $263.03 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.30 Median $26.30 Typical High $28.84 | Professional | RR · Rental | $26.30 | $26.30 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | UE · Used equipment | $199.53 | $199.53 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $398.11 | Facility | None | $275.42 | $275.42 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $616.60 | Professional | None | $213.80 | $478.63 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $363.08 | Professional | None | $263.03 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Facility | None | $190.55 | $190.55 | $229.09 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $758.58 | Professional | None | $213.80 | $269.15 | $758.58 |
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 $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $138.04 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $138.04 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $54.95 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $40.74 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $27.54 | $36.31 | $36.31 |
Where Maine sits
The same service costs 2.5 times more in Hawaii than in Florida. 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· 32nd of 51
$275
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.