How much rates vary
Facilitymedian $4,677 · 10th to 90th $2,692 to $9,120Professionalmedian $1,738 · 10th to 90th $1,514 to $3,311
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 $1,737.80 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,570.40 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $4,786.30 Typical High $9,120.11 | Facility | None | $3,801.89 | $4,786.30 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,905.46 | Professional | None | $1,698.24 | $1,698.24 | $1,905.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | RR · Rental | $169.82 | $169.82 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,288.25 Median $1,288.25 Typical High $1,412.54 | Professional | UE · Used equipment | $1,288.25 | $1,288.25 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,818.38 | Facility | None | $2,041.74 | $2,041.74 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,513.56 | $2,041.74 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,479.11 Median $3,311.31 Typical High $4,365.16 | Professional | None | $1,479.11 | $3,311.31 | $4,365.16 |
Martin's Point Setting Professional Modifier None Typical Low $1,737.80 Median $2,570.40 Typical High $2,570.40 | Professional | None | $1,737.80 | $2,570.40 | $2,570.40 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $1,949.84 | Facility | None | $1,905.46 | $1,905.46 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,380.38 Median $1,905.46 Typical High $5,248.07 | Professional | None | $1,380.38 | $1,905.46 | $5,248.07 |
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 $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $851.14 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $346.74 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $257.04 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $173.78 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,288.25 Typical High $1,288.25 | Professional | 52 · Reduced service | $851.14 | $1,288.25 | $1,288.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $512.86 Typical High $512.86 | Professional | 53 · Discontinued | $346.74 | $512.86 | $512.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $257.04 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $173.78 Median $257.04 Typical High $257.04 | Professional | 56 · Pre-op care only | $173.78 | $257.04 | $257.04 |
Where Maine sits
The same service costs 3.1 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· 27th of 51
$1,905
HI $4,677PA $1,514
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.