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 $218.78 Median $281.84 Typical High $281.84 | Professional | None | $218.78 | $281.84 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $524.81 Typical High $1,000.00 | Facility | None | $407.38 | $524.81 | $1,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | None | $186.21 | $218.78 | $245.47 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $21.88 Median $21.88 Typical High $24.55 | Professional | RR · Rental | $21.88 | $21.88 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | UE · Used equipment | $165.96 | $165.96 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $302.00 | Facility | None | $229.09 | $229.09 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $478.63 | Professional | None | $162.18 | $363.08 | $478.63 |
Martin's Point Setting Professional Modifier None Typical Low $218.78 Median $281.84 Typical High $281.84 | Professional | None | $218.78 | $281.84 | $281.84 |
United Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $190.55 | Facility | None | $151.36 | $151.36 | $190.55 |
United Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $575.44 | Professional | None | $162.18 | $208.93 | $575.44 |
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 $112.20 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $112.20 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $44.67 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.39 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $112.20 Median $141.25 Typical High $141.25 | Professional | 52 · Reduced service | $112.20 | $141.25 | $141.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $56.23 Typical High $56.23 | Professional | 53 · Discontinued | $44.67 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | 55 · Aftercare only | $33.11 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $28.18 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.39 | $28.18 | $28.18 |
Where Maine sits
The same service costs 2.7 times more in Montana 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
$229
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.