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 $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $512.86 Typical High $977.24 | Facility | None | $398.11 | $512.86 | $977.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $331.13 Typical High $354.81 | Professional | None | $323.59 | $331.13 | $354.81 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $32.36 Median $32.36 Typical High $35.48 | Professional | RR · Rental | $32.36 | $32.36 | $35.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $239.88 Median $239.88 Typical High $263.03 | Professional | UE · Used equipment | $239.88 | $239.88 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $295.12 | Facility | None | $263.03 | $263.03 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $467.74 | Professional | None | $165.96 | $354.81 | $467.74 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $269.15 Typical High $269.15 | Professional | None | $257.04 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Facility | None | $263.03 | $263.03 | $263.03 |
United Setting Professional Modifier None Typical Low $158.49 Median $199.53 Typical High $562.34 | Professional | None | $158.49 | $199.53 | $562.34 |
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 $125.89 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $125.89 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $51.29 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $26.92 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $125.89 Median $134.90 Typical High $134.90 | Professional | 52 · Reduced service | $125.89 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $53.70 Typical High $53.70 | Professional | 53 · Discontinued | $51.29 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $40.74 Typical High $40.74 | Professional | 55 · Aftercare only | $38.02 | $40.74 | $40.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $26.92 Typical High $26.92 | Professional | 56 · Pre-op care only | $25.70 | $26.92 | $26.92 |
Where Maine sits
The same service costs 3.0 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· 19th of 51
$324
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.