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 $537.03 Typical High $537.03 | Professional | None | $354.81 | $537.03 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,905.46 | Facility | None | $776.25 | $1,000.00 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $398.11 | Professional | None | $363.08 | $363.08 | $398.11 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $36.31 Median $36.31 Typical High $39.81 | Professional | RR · Rental | $36.31 | $36.31 | $39.81 |
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 $398.11 Median $398.11 Typical High $575.44 | Facility | None | $398.11 | $398.11 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $912.01 | Professional | None | $309.03 | $691.83 | $912.01 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $537.03 Typical High $537.03 | Professional | None | $354.81 | $537.03 | $537.03 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $1,096.48 | Professional | None | $275.42 | $398.11 | $1,096.48 |
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 $186.21 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $56.23 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $186.21 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $74.13 | $107.15 | $107.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $56.23 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $37.15 | $53.70 | $53.70 |
Where Maine sits
The same service costs 3.7 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· 24th of 51
$398
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.