How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,349 to $4,571Professionalmedian $891 · 10th to 90th $871 to $1,698
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 $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | None | $912.01 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $4,570.88 | Facility | None | $1,905.46 | $2,454.71 | $4,570.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $891.25 Typical High $954.99 | Professional | None | $870.96 | $891.25 | $954.99 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | RR · Rental | $87.10 | $87.10 | $95.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | UE · Used equipment | $660.69 | $660.69 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Facility | None | $1,202.26 | $1,202.26 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,202.26 | Professional | None | $870.96 | $870.96 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $758.58 Median $1,698.24 Typical High $2,187.76 | Professional | None | $758.58 | $1,698.24 | $2,187.76 |
Martin's Point Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $1,288.25 | Professional | None | $912.01 | $1,288.25 | $1,288.25 |
United Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $724.44 | Facility | None | $457.09 | $457.09 | $724.44 |
United Setting Professional Modifier None Typical Low $676.08 Median $954.99 Typical High $2,691.53 | Professional | None | $676.08 | $954.99 | $2,691.53 |
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 $457.09 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $457.09 | $645.65 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $181.97 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $91.20 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $457.09 Median $645.65 Typical High $645.65 | Professional | 52 · Reduced service | $457.09 | $645.65 | $645.65 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $257.04 Typical High $257.04 | Professional | 53 · Discontinued | $181.97 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $134.90 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $128.82 Typical High $128.82 | Professional | 56 · Pre-op care only | $91.20 | $128.82 | $128.82 |
Where Maine sits
The same service costs 2.6 times more in Montana 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· 31st of 51
$955
MT $1,950FL $759
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.