How much rates vary
Facilitymedian $6,761 · 10th to 90th $3,981 to $13,183Professionalmedian $3,162 · 10th to 90th $2,570 to $4,786
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 $3,162.28 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,715.35 | $3,715.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,370.32 Median $6,918.31 Typical High $13,182.57 | Facility | None | $5,370.32 | $6,918.31 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,467.37 | Professional | None | $3,162.28 | $3,162.28 | $3,467.37 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | RR · Rental | $316.23 | $316.23 | $346.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,398.83 Median $2,398.83 Typical High $2,630.27 | Professional | UE · Used equipment | $2,398.83 | $2,398.83 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $3,715.35 Median $3,715.35 Typical High $3,981.07 | Facility | None | $3,715.35 | $3,715.35 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,715.35 | Professional | None | $2,754.23 | $2,754.23 | $3,715.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,187.76 Median $4,786.30 Typical High $6,309.57 | Professional | None | $2,187.76 | $4,786.30 | $6,309.57 |
Martin's Point Setting Professional Modifier None Typical Low $3,162.28 Median $3,715.35 Typical High $3,715.35 | Professional | None | $3,162.28 | $3,715.35 | $3,715.35 |
United Setting Facility Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $3,467.37 | Facility | None | $3,467.37 | $3,467.37 | $3,467.37 |
United Setting Professional Modifier None Typical Low $2,137.96 Median $2,754.23 Typical High $7,585.78 | Professional | None | $2,137.96 | $2,754.23 | $7,585.78 |
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 $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,548.82 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $630.96 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $467.74 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $316.23 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,548.82 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $1,548.82 | $1,862.09 | $1,862.09 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $630.96 | $741.31 | $741.31 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $467.74 | $549.54 | $549.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $316.23 | $371.54 | $371.54 |
Where Maine sits
The same service costs 2.9 times more in Hawaii than in Pennsylvania. 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
$3,467
HI $7,943PA $2,754
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.