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 $257.04 Median $331.13 Typical High $331.13 | Professional | None | $257.04 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $478.63 Median $616.60 Typical High $1,174.90 | Facility | None | $478.63 | $616.60 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | None | $269.15 | $269.15 | $295.12 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $26.92 Typical High $29.51 | Professional | RR · Rental | $26.92 | $26.92 | $29.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $199.53 Median $199.53 Typical High $223.87 | Professional | UE · Used equipment | $199.53 | $199.53 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $354.81 | Facility | None | $281.84 | $281.84 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $281.84 | Professional | None | $204.17 | $204.17 | $281.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $190.55 Median $426.58 Typical High $562.34 | Professional | None | $190.55 | $426.58 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $331.13 | Professional | None | $257.04 | $331.13 | $331.13 |
United Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $389.05 | Facility | None | $288.40 | $288.40 | $389.05 |
United Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $676.08 | Professional | None | $190.55 | $245.47 | $676.08 |
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 $128.82 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $33.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $66.07 | $66.07 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $48.98 | $48.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $33.11 | $33.11 |
Where Maine sits
The same service costs 4.1 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· 26th of 51
$282
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.