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 $354.81 Median $478.63 Typical High $478.63 | Professional | None | $354.81 | $478.63 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $707.95 Median $912.01 Typical High $1,698.24 | Facility | None | $707.95 | $912.01 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $426.58 | Professional | None | $380.19 | $380.19 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | RR · Rental | $38.02 | $38.02 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $288.40 Median $288.40 Typical High $316.23 | Professional | UE · Used equipment | $288.40 | $288.40 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $524.81 | Facility | None | $398.11 | $398.11 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $398.11 | Professional | None | $288.40 | $288.40 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $275.42 Median $630.96 Typical High $812.83 | Professional | None | $275.42 | $630.96 | $812.83 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $478.63 | Professional | None | $354.81 | $478.63 | $478.63 |
United Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Facility | None | $363.08 | $363.08 | $363.08 |
United Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $977.24 | Professional | None | $275.42 | $354.81 | $977.24 |
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 $190.55 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $47.86 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $190.55 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $190.55 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $75.86 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 55 · Aftercare only | $57.54 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $47.86 |
Where Maine sits
The same service costs 2.8 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· 31st of 51
$398
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.