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 $363.08 Median $562.34 Typical High $562.34 | Professional | None | $363.08 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Facility | None | $812.83 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $512.86 | Professional | None | $457.09 | $457.09 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | RR · Rental | $45.71 | $45.71 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | UE · Used equipment | $346.74 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $616.60 | Facility | None | $389.05 | $389.05 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $389.05 | Professional | None | $281.84 | $281.84 | $389.05 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $954.99 | Professional | None | $323.59 | $724.44 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $562.34 | Professional | None | $363.08 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $331.13 | Facility | None | $281.84 | $281.84 | $331.13 |
United Setting Professional Modifier None Typical Low $288.40 Median $416.87 Typical High $1,148.15 | Professional | None | $288.40 | $416.87 | $1,148.15 |
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 $186.21 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $74.13 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $37.15 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $186.21 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $186.21 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $74.13 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $56.23 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $37.15 | $56.23 | $56.23 |
Where Maine sits
The same service costs 2.6 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· 22nd of 51
$479
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.