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 $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $575.44 Median $741.31 Typical High $1,412.54 | Facility | None | $575.44 | $741.31 | $1,412.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $363.08 Typical High $389.05 | Professional | None | $354.81 | $363.08 | $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 $269.15 Median $269.15 Typical High $295.12 | Professional | UE · Used equipment | $269.15 | $269.15 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $426.58 | Facility | None | $380.19 | $380.19 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $245.47 Median $512.86 Typical High $676.08 | Professional | None | $245.47 | $512.86 | $676.08 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
United Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $389.05 | Facility | None | $346.74 | $346.74 | $389.05 |
United Setting Professional Modifier None Typical Low $229.09 Median $295.12 Typical High $812.83 | Professional | None | $229.09 | $295.12 | $812.83 |
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 $194.98 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $194.98 | $199.53 | $199.53 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $77.62 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.90 | $39.81 | $39.81 |
Where Maine sits
The same service costs 3.2 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· 35th of 51
$363
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.