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 $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $194.98 Typical High $371.54 | Facility | None | $151.36 | $194.98 | $371.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | None | $93.33 | $93.33 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | RR · Rental | $9.33 | $9.33 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | UE · Used equipment | $69.18 | $69.18 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $112.20 | Facility | None | $100.00 | $100.00 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $64.57 Median $134.90 Typical High $177.83 | Professional | None | $64.57 | $134.90 | $177.83 |
Martin's Point Setting Professional Modifier None Typical Low $97.72 Median $102.33 Typical High $102.33 | Professional | None | $97.72 | $102.33 | $102.33 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $75.86 | Facility | None | $60.26 | $60.26 | $75.86 |
United Setting Professional Modifier None Typical Low $60.26 Median $75.86 Typical High $213.80 | Professional | None | $60.26 | $75.86 | $213.80 |
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 $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 52 · Reduced service | $51.29 | $51.29 | $51.29 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $20.89 | Professional | 53 · Discontinued | $20.42 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.14 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.23 |
Where Maine sits
The same service costs 2.9 times more in Montana than in Florida. 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· 31st of 51
$95.50
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.