How much rates vary
Facilitymedian $5,495 · 10th to 90th $3,388 to $10,715Professionalmedian $2,512 · 10th to 90th $2,089 to $3,890
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 $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,344.23 | $3,019.95 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,365.16 Median $5,623.41 Typical High $10,715.19 | Facility | None | $4,365.16 | $5,623.41 | $10,715.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,754.23 | Professional | None | $2,511.89 | $2,511.89 | $2,754.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | RR · Rental | $251.19 | $251.19 | $275.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,905.46 Median $1,905.46 Typical High $2,089.30 | Professional | UE · Used equipment | $1,905.46 | $1,905.46 | $2,089.30 |
Cigna Setting Facility Modifier None Typical Low $3,090.30 Median $3,388.44 Typical High $3,388.44 | Facility | None | $3,090.30 | $3,388.44 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,454.71 | $3,388.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,737.80 Median $3,890.45 Typical High $5,128.61 | Professional | None | $1,737.80 | $3,890.45 | $5,128.61 |
Martin's Point Setting Professional Modifier None Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,344.23 | $3,019.95 | $3,019.95 |
United Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Facility | None | $2,398.83 | $2,398.83 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,737.80 Median $2,238.72 Typical High $6,165.95 | Professional | None | $1,737.80 | $2,238.72 | $6,165.95 |
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 $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $602.56 | $602.56 |
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 $245.47 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $302.00 | $302.00 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,230.27 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,230.27 | $1,513.56 | $1,513.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $602.56 Typical High $602.56 | Professional | 53 · Discontinued | $489.78 | $602.56 | $602.56 |
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 $245.47 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $245.47 | $302.00 | $302.00 |
Where Maine sits
The same service costs 2.1 times more in Montana than in South Carolina. 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· 30th of 51
$2,570
MT $4,898SC $2,344
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.