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 $436.52 Typical High $436.52 | Professional | None | $316.23 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $630.96 Median $812.83 Typical High $1,548.82 | Facility | None | $630.96 | $812.83 | $1,548.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $346.74 | Professional | None | $269.15 | $316.23 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | RR · Rental | $31.62 | $31.62 | $34.67 |
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 $338.84 Median $338.84 Typical High $478.63 | Facility | None | $338.84 | $338.84 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $338.84 | Professional | None | $245.47 | $245.47 | $338.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $251.19 Median $562.34 Typical High $741.31 | Professional | None | $251.19 | $562.34 | $741.31 |
Martin's Point Setting Professional Modifier None Typical Low $316.23 Median $436.52 Typical High $436.52 | Professional | None | $316.23 | $436.52 | $436.52 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Facility | None | $263.03 | $263.03 | $363.08 |
United Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $891.25 | Professional | None | $245.47 | $323.59 | $891.25 |
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 $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $43.65 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $218.78 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $218.78 | $218.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $87.10 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $64.57 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $43.65 | $43.65 |
Where Maine sits
The same service costs 2.8 times more in Wyoming 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· 31st of 51
$324
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.