How much rates vary
Facilitymedian $2,630 · 10th to 90th $1,514 to $5,129Professionalmedian $1,122 · 10th to 90th $1,023 to $1,862
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 $1,096.48 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,445.44 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,089.30 Median $2,691.53 Typical High $5,128.61 | Facility | None | $2,089.30 | $2,691.53 | $5,128.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,230.27 | Professional | None | $1,122.02 | $1,122.02 | $1,230.27 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $112.20 Median $112.20 Typical High $123.03 | Professional | RR · Rental | $112.20 | $112.20 | $123.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $851.14 Median $851.14 Typical High $933.25 | Professional | UE · Used equipment | $851.14 | $851.14 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,584.89 | Facility | None | $1,412.54 | $1,412.54 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,023.29 | $1,412.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $831.76 Median $1,862.09 Typical High $2,454.71 | Professional | None | $831.76 | $1,862.09 | $2,454.71 |
Martin's Point Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,096.48 | $1,445.44 | $1,445.44 |
United Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,318.26 | Facility | None | $1,230.27 | $1,230.27 | $1,318.26 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $2,951.21 | Professional | None | $831.76 | $1,071.52 | $2,951.21 |
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 $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $616.60 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $245.47 | $288.40 | $288.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $123.03 | $144.54 | $144.54 |
Where Maine sits
The same service costs 3.6 times more in Hawaii than in Washington, DC. 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
$1,148
HI $3,548DC $977
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.