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 $95.50 Median $125.89 Typical High $125.89 | Professional | None | $95.50 | $125.89 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $186.21 Median $239.88 Typical High $457.09 | Facility | None | $186.21 | $239.88 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $107.15 | Professional | None | $95.50 | $95.50 | $107.15 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.55 Median $9.55 Typical High $10.72 | Professional | RR · Rental | $9.55 | $9.55 | $10.72 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $72.44 Median $72.44 Typical High $79.43 | Professional | UE · Used equipment | $72.44 | $72.44 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $138.04 | Facility | None | $100.00 | $100.00 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $218.78 | Professional | None | $74.13 | $165.96 | $218.78 |
Martin's Point Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $125.89 | Professional | None | $95.50 | $125.89 | $125.89 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Facility | None | $102.33 | $102.33 | $107.15 |
United Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $263.03 | Professional | None | $74.13 | $93.33 | $263.03 |
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 $50.12 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $50.12 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $19.95 | $25.70 | $25.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $19.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.00 | $12.59 | $12.59 |
Where Maine sits
The same service costs 4.1 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· 29th of 51
$100
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.