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 $549.54 Median $776.25 Typical High $776.25 | Professional | None | $549.54 | $776.25 | $776.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,445.44 Typical High $2,754.23 | Facility | None | $1,148.15 | $1,445.44 | $2,754.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $446.68 Median $524.81 Typical High $575.44 | Professional | None | $446.68 | $524.81 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $52.48 Median $52.48 Typical High $57.54 | Professional | RR · Rental | $52.48 | $52.48 | $57.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | UE · Used equipment | $389.05 | $389.05 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $851.14 | Facility | None | $588.84 | $588.84 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $588.84 | Professional | None | $426.58 | $426.58 | $588.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $446.68 Median $1,000.00 Typical High $1,318.26 | Professional | None | $446.68 | $1,000.00 | $1,318.26 |
Martin's Point Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $776.25 | Professional | None | $549.54 | $776.25 | $776.25 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Facility | None | $501.19 | $501.19 | $524.81 |
United Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $1,584.89 | Professional | None | $407.38 | $575.44 | $1,584.89 |
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 $269.15 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $109.65 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $81.28 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $77.62 | $77.62 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $269.15 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $269.15 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $109.65 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $81.28 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $54.95 | $77.62 | $77.62 |
Where Maine sits
The same service costs 2.8 times more in Hawaii than in West Virginia. 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
$550
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.