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 $524.81 Median $794.33 Typical High $794.33 | Professional | None | $524.81 | $794.33 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,148.15 Median $1,479.11 Typical High $2,818.38 | Facility | None | $1,148.15 | $1,479.11 | $2,818.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $588.84 | Professional | None | $537.03 | $537.03 | $588.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $53.70 Median $53.70 Typical High $58.88 | Professional | RR · Rental | $53.70 | $53.70 | $58.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $398.11 Median $398.11 Typical High $436.52 | Professional | UE · Used equipment | $398.11 | $398.11 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Facility | None | $616.60 | $616.60 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $616.60 | Professional | None | $446.68 | $446.68 | $616.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $457.09 Median $1,023.29 Typical High $1,348.96 | Professional | None | $457.09 | $1,023.29 | $1,348.96 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $794.33 | Professional | None | $524.81 | $794.33 | $794.33 |
United Setting Facility Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Facility | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $1,621.81 | Professional | None | $407.38 | $588.84 | $1,621.81 |
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 $275.42 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $275.42 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $275.42 Median $389.05 Typical High $389.05 | Professional | 52 · Reduced service | $275.42 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $158.49 Typical High $158.49 | Professional | 53 · Discontinued | $109.65 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $117.49 Typical High $117.49 | Professional | 55 · Aftercare only | $83.18 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $79.43 Typical High $79.43 | Professional | 56 · Pre-op care only | $54.95 | $79.43 | $79.43 |
Where Maine sits
The same service costs 3.7 times more in Hawaii than in Tennessee. 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· 34th 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.