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 $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,090.30 | Facility | None | $1,258.93 | $1,621.81 | $3,090.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $776.25 | Professional | None | $588.84 | $691.83 | $776.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $69.18 Median $69.18 Typical High $77.62 | Professional | RR · Rental | $69.18 | $69.18 | $77.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $524.81 Median $524.81 Typical High $575.44 | Professional | UE · Used equipment | $524.81 | $524.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $933.25 Typical High $954.99 | Facility | None | $912.01 | $933.25 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $933.25 | Professional | None | $676.08 | $676.08 | $933.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $501.19 Median $1,122.02 Typical High $1,479.11 | Professional | None | $501.19 | $1,122.02 | $1,479.11 |
Martin's Point Setting Professional Modifier None Typical Low $691.83 Median $870.96 Typical High $870.96 | Professional | None | $691.83 | $870.96 | $870.96 |
United Setting Facility Modifier None Typical Low $478.63 Median $478.63 Typical High $575.44 | Facility | None | $478.63 | $478.63 | $575.44 |
United Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $1,778.28 | Professional | None | $501.19 | $645.65 | $1,778.28 |
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 $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $363.08 Median $436.52 Typical High $436.52 | Professional | 52 · Reduced service | $363.08 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $173.78 | Professional | 53 · Discontinued | $144.54 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $87.10 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $87.10 |
Where Maine sits
The same service costs 2.1 times more in Wisconsin 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· 32nd of 51
$724
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.