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 $120.23 Median $147.91 Typical High $147.91 | Professional | None | $120.23 | $147.91 | $147.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $524.81 | Facility | None | $218.78 | $281.84 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $131.83 | Professional | None | $120.23 | $120.23 | $131.83 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | RR · Rental | $12.02 | $12.02 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $89.13 Median $89.13 Typical High $100.00 | Professional | UE · Used equipment | $89.13 | $89.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $162.18 | Facility | None | $123.03 | $123.03 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $123.03 | Professional | None | $89.13 | $89.13 | $123.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $85.11 Median $194.98 Typical High $251.19 | Professional | None | $85.11 | $194.98 | $251.19 |
Martin's Point Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $147.91 | Professional | None | $120.23 | $147.91 | $147.91 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $302.00 | Professional | None | $85.11 | $109.65 | $302.00 |
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 $61.66 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $24.55 | $29.51 | $29.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $14.79 |
Where Maine sits
The same service costs 3.0 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
$123
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.