How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,259 to $4,074Professionalmedian $912 · 10th to 90th $776 to $1,514
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 $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | None | $812.83 | $1,148.15 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $4,073.80 | Facility | None | $1,698.24 | $2,187.76 | $4,073.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,000.00 | Professional | None | $912.01 | $912.01 | $1,000.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $91.20 Median $91.20 Typical High $100.00 | Professional | RR · Rental | $91.20 | $91.20 | $100.00 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $676.08 Median $676.08 Typical High $741.31 | Professional | UE · Used equipment | $676.08 | $676.08 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,230.27 Typical High $1,258.93 | Facility | None | $1,202.26 | $1,230.27 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $891.25 Typical High $1,230.27 | Professional | None | $891.25 | $891.25 | $1,230.27 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $676.08 Median $1,513.56 Typical High $1,949.84 | Professional | None | $676.08 | $1,513.56 | $1,949.84 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $1,148.15 Typical High $1,148.15 | Professional | None | $812.83 | $1,148.15 | $1,148.15 |
United Setting Facility Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Facility | None | $851.14 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $676.08 Median $851.14 Typical High $2,398.83 | Professional | None | $676.08 | $851.14 | $2,398.83 |
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 $446.68 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $446.68 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $446.68 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $177.83 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $134.90 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $89.13 | $114.82 | $114.82 |
Where Maine sits
The same service costs 2.1 times more in Wisconsin 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· 28th of 51
$1,000
WI $1,820FL $871
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.