How much rates vary
Facilitymedian $5,370 · 10th to 90th $3,090 to $10,471Professionalmedian $2,754 · 10th to 90th $1,820 to $3,802
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 $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $5,495.41 Typical High $10,471.29 | Facility | None | $4,365.16 | $5,495.41 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,754.23 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,754.23 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | RR · Rental | $269.15 | $269.15 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,238.72 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,235.94 | Facility | None | $2,511.89 | $2,511.89 | $3,235.94 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,819.70 | $1,819.70 | $2,511.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,698.24 Median $3,801.89 Typical High $5,011.87 | Professional | None | $1,698.24 | $3,801.89 | $5,011.87 |
Martin's Point Setting Professional Modifier None Typical Low $2,290.87 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,290.87 | $2,951.21 | $2,951.21 |
United Setting Facility Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Facility | None | $2,187.76 | $2,187.76 | $2,187.76 |
United Setting Professional Modifier None Typical Low $1,698.24 Median $2,187.76 Typical High $6,025.60 | Professional | None | $1,698.24 | $2,187.76 | $6,025.60 |
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 $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $363.08 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,479.11 Typical High $1,479.11 | Professional | 52 · Reduced service | $1,202.26 | $1,479.11 | $1,479.11 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $588.84 Typical High $588.84 | Professional | 53 · Discontinued | $478.63 | $588.84 | $588.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | 55 · Aftercare only | $363.08 | $446.68 | $446.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $295.12 Typical High $295.12 | Professional | 56 · Pre-op care only | $239.88 | $295.12 | $295.12 |
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· 24th of 51
$2,754
HI $4,786DE $1,820
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.