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 $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $691.83 Median $891.25 Typical High $1,698.24 | Facility | None | $691.83 | $891.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $354.81 | Professional | None | $323.59 | $331.13 | $354.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | RR · Rental | $32.36 | $32.36 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | UE · Used equipment | $239.88 | $239.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $512.86 | Facility | None | $331.13 | $331.13 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $331.13 | Professional | None | $239.88 | $239.88 | $331.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $616.60 Typical High $812.83 | Professional | None | $275.42 | $616.60 | $812.83 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $263.03 | Facility | None | $218.78 | $218.78 | $263.03 |
United Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $977.24 | Professional | None | $263.03 | $354.81 | $977.24 |
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 $165.96 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $165.96 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $165.96 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $66.07 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $50.12 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.11 | $47.86 | $47.86 |
Where Maine sits
The same service costs 2.4 times more in Arkansas 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· 35th of 51
$331
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.