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 $281.84 Median $371.54 Typical High $371.54 | Professional | None | $281.84 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $1,318.26 | Facility | None | $537.03 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $30.90 Typical High $33.88 | Professional | RR · Rental | $30.90 | $30.90 | $33.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $229.09 Median $229.09 Typical High $251.19 | Professional | UE · Used equipment | $229.09 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $398.11 | Facility | None | $363.08 | $363.08 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $363.08 | Professional | None | $263.03 | $263.03 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $630.96 | Professional | None | $213.80 | $478.63 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $281.84 Median $371.54 Typical High $371.54 | Professional | None | $281.84 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $758.58 | Professional | None | $213.80 | $275.42 | $758.58 |
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 $151.36 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $151.36 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $151.36 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $151.36 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $60.26 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $44.67 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $37.15 | $37.15 |
Where Maine sits
The same service costs 2.2 times more in Montana 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· 28th of 51
$339
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.