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 $229.09 Median $338.84 Typical High $338.84 | Professional | None | $229.09 | $338.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $501.19 Median $645.65 Typical High $1,230.27 | Facility | None | $501.19 | $645.65 | $1,230.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $239.88 Typical High $257.04 | Professional | None | $229.09 | $239.88 | $257.04 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $22.91 Median $22.91 Typical High $25.70 | Professional | RR · Rental | $22.91 | $22.91 | $25.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | UE · Used equipment | $173.78 | $173.78 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $371.54 | Facility | None | $245.47 | $245.47 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $245.47 | Professional | None | $181.97 | $181.97 | $245.47 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $199.53 Median $446.68 Typical High $588.84 | Professional | None | $199.53 | $446.68 | $588.84 |
Martin's Point Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $338.84 | Professional | None | $229.09 | $338.84 | $338.84 |
United Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $245.47 | Facility | None | $190.55 | $190.55 | $245.47 |
United Setting Professional Modifier None Typical Low $190.55 Median $251.19 Typical High $707.95 | Professional | None | $190.55 | $251.19 | $707.95 |
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 $120.23 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $33.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $169.82 Typical High $169.82 | Professional | 52 · Reduced service | $120.23 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $69.18 Typical High $69.18 | Professional | 53 · Discontinued | $47.86 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $51.29 Typical High $51.29 | Professional | 55 · Aftercare only | $36.31 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $33.88 Typical High $33.88 | Professional | 56 · Pre-op care only | $23.99 | $33.88 | $33.88 |
Where Maine sits
The same service costs 2.5 times more in Kansas 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· 37th of 51
$245
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.