How much rates vary
Facilitymedian $2,138 · 10th to 90th $1,202 to $4,169Professionalmedian $813 · 10th to 90th $661 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 $4,168.69 | Facility | None | $1,698.24 | $2,187.76 | $4,168.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $870.96 | Professional | None | $794.33 | $794.33 | $870.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $79.43 Median $79.43 Typical High $87.10 | Professional | RR · Rental | $79.43 | $79.43 | $87.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | UE · Used equipment | $588.84 | $588.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Facility | None | $912.01 | $912.01 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $912.01 | Professional | None | $660.69 | $660.69 | $912.01 |
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 $575.44 Median $575.44 Typical High $676.08 | Facility | None | $575.44 | $575.44 | $676.08 |
United Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $2,398.83 | Professional | None | $602.56 | $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 $407.38 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $229.09 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $575.44 Typical High $575.44 | Professional | 52 · Reduced service | $407.38 | $575.44 | $575.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $229.09 Typical High $229.09 | Professional | 53 · Discontinued | $162.18 | $229.09 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $173.78 Typical High $173.78 | Professional | 55 · Aftercare only | $123.03 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $114.82 Typical High $114.82 | Professional | 56 · Pre-op care only | $81.28 | $114.82 | $114.82 |
Where Maine sits
The same service costs 2.3 times more in Hawaii than in New Jersey. 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· 33rd of 51
$851
HI $1,514NJ $661
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.