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 $158.49 Median $245.47 Typical High $245.47 | Professional | None | $158.49 | $245.47 | $245.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $870.96 | Facility | None | $363.08 | $457.09 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | None | $169.82 | $169.82 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | RR · Rental | $16.98 | $16.98 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | UE · Used equipment | $128.82 | $128.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $269.15 | Facility | None | $173.78 | $173.78 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $416.87 | Professional | None | $141.25 | $316.23 | $416.87 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $245.47 | Professional | None | $158.49 | $245.47 | $245.47 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $229.09 | Facility | None | $186.21 | $186.21 | $229.09 |
United Setting Professional Modifier None Typical Low $138.04 Median $181.97 Typical High $501.19 | Professional | None | $138.04 | $181.97 | $501.19 |
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 $83.18 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $83.18 Median $123.03 Typical High $123.03 | Professional | 52 · Reduced service | $83.18 | $123.03 | $123.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $48.98 Typical High $48.98 | Professional | 53 · Discontinued | $33.88 | $48.98 | $48.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $37.15 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $24.55 Typical High $24.55 | Professional | 56 · Pre-op care only | $16.98 | $24.55 | $24.55 |
Where Maine sits
The same service costs 4.0 times more in Hawaii 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· 33rd of 51
$178
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.