How much rates vary
Facilitymedian $2,239 · 10th to 90th $1,259 to $4,266Professionalmedian $851 · 10th to 90th $631 to $1,585
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 $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,778.28 Median $2,290.87 Typical High $4,265.80 | Facility | None | $1,778.28 | $2,290.87 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $912.01 | Professional | None | $812.83 | $812.83 | $912.01 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $81.28 Median $81.28 Typical High $91.20 | Professional | RR · Rental | $81.28 | $81.28 | $91.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $616.60 Median $616.60 Typical High $676.08 | Professional | UE · Used equipment | $616.60 | $616.60 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $870.96 Typical High $1,318.26 | Facility | None | $870.96 | $870.96 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $870.96 | Professional | None | $630.96 | $630.96 | $870.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,041.74 | Professional | None | $707.95 | $1,584.89 | $2,041.74 |
Martin's Point Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,202.26 | Professional | None | $891.25 | $1,202.26 | $1,202.26 |
United Setting Facility Modifier None Typical Low $891.25 Median $891.25 Typical High $1,513.56 | Facility | None | $891.25 | $891.25 | $1,513.56 |
United Setting Professional Modifier None Typical Low $645.65 Median $891.25 Typical High $2,511.89 | Professional | None | $645.65 | $891.25 | $2,511.89 |
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 $446.68 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $446.68 | $602.56 | $602.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $177.83 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $134.90 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $89.13 | $120.23 | $120.23 |
Where Maine sits
The same service costs 4.0 times more in Hawaii than in Delaware. 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· 27th of 51
$891
HI $2,512DE $631
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.