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 $323.59 Median $446.68 Typical High $446.68 | Professional | None | $323.59 | $446.68 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $645.65 Median $831.76 Typical High $1,584.89 | Facility | None | $645.65 | $831.76 | $1,584.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $389.05 | Professional | None | $354.81 | $354.81 | $389.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $35.48 Median $35.48 Typical High $38.90 | Professional | RR · Rental | $35.48 | $35.48 | $38.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $263.03 Median $263.03 Typical High $288.40 | Professional | UE · Used equipment | $263.03 | $263.03 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $501.19 Typical High $501.19 | Facility | None | $457.09 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $501.19 | Professional | None | $363.08 | $363.08 | $501.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $257.04 Median $575.44 Typical High $758.58 | Professional | None | $257.04 | $575.44 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $323.59 Median $446.68 Typical High $446.68 | Professional | None | $323.59 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $288.40 | Facility | None | $229.09 | $229.09 | $288.40 |
United Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $912.01 | Professional | None | $257.04 | $331.13 | $912.01 |
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 $173.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $173.78 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $173.78 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $69.18 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $66.07 Typical High $66.07 | Professional | 55 · Aftercare only | $52.48 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $34.67 | $44.67 | $44.67 |
Where Maine sits
The same service costs 2.3 times more in Wisconsin 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· 30th of 51
$389
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.