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 $125.89 Median $190.55 Typical High $190.55 | Professional | None | $125.89 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $363.08 Typical High $676.08 | Facility | None | $281.84 | $363.08 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | None | $134.90 | $134.90 | $147.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.49 Median $13.49 Typical High $14.79 | Professional | RR · Rental | $13.49 | $13.49 | $14.79 |
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 $138.04 Median $138.04 Typical High $208.93 | Facility | None | $138.04 | $138.04 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $138.04 | Professional | None | $102.33 | $102.33 | $138.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $112.20 Median $251.19 Typical High $323.59 | Professional | None | $112.20 | $251.19 | $323.59 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $190.55 Typical High $190.55 | Professional | None | $125.89 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $398.11 | Professional | None | $109.65 | $141.25 | $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 $66.07 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $19.05 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $66.07 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $19.05 | $19.05 |
Where Maine sits
The same service costs 3.5 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· 27th 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.