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 $131.83 Median $194.98 Typical High $194.98 | Professional | None | $131.83 | $194.98 | $194.98 |
Anthem BCBS Setting Facility Modifier None Typical Low $288.40 Median $371.54 Typical High $691.83 | Facility | None | $288.40 | $371.54 | $691.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $144.54 | Professional | None | $131.83 | $134.90 | $144.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.18 Median $13.18 Typical High $14.45 | Professional | RR · Rental | $13.18 | $13.18 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $100.00 Median $100.00 Typical High $109.65 | Professional | UE · Used equipment | $100.00 | $100.00 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $213.80 | Facility | None | $141.25 | $141.25 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $141.25 | Professional | None | $102.33 | $102.33 | $141.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $331.13 | Professional | None | $112.20 | $251.19 | $331.13 |
Martin's Point Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $194.98 | Professional | None | $131.83 | $194.98 | $194.98 |
United Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $158.49 | Facility | None | $144.54 | $144.54 | $158.49 |
United Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $398.11 | Professional | None | $102.33 | $144.54 | $398.11 |
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 $69.18 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $69.18 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $38.90 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $19.50 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $69.18 Median $97.72 Typical High $97.72 | Professional | 52 · Reduced service | $69.18 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.90 Typical High $38.90 | Professional | 53 · Discontinued | $27.54 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $29.51 Typical High $29.51 | Professional | 55 · Aftercare only | $20.42 | $29.51 | $29.51 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.50 Typical High $19.50 | Professional | 56 · Pre-op care only | $13.80 | $19.50 | $19.50 |
Where Maine sits
The same service costs 3.7 times more in Hawaii 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· 30th of 51
$141
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.