How much rates vary
Facilitymedian $6,457 · 10th to 90th $3,631 to $12,589Professionalmedian $2,692 · 10th to 90th $2,042 to $4,571
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 $2,691.53 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,548.13 | $3,548.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $5,128.61 Median $6,606.93 Typical High $12,589.25 | Facility | None | $5,128.61 | $6,606.93 | $12,589.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Professional | None | $2,691.53 | $2,691.53 | $2,951.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $269.15 Median $269.15 Typical High $295.12 | Professional | RR · Rental | $269.15 | $269.15 | $295.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,041.74 Median $2,041.74 Typical High $2,238.72 | Professional | UE · Used equipment | $2,041.74 | $2,041.74 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $3,801.89 | Facility | None | $2,754.23 | $2,754.23 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,754.23 | Professional | None | $2,041.74 | $2,041.74 | $2,754.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,041.74 Median $4,570.88 Typical High $6,025.60 | Professional | None | $2,041.74 | $4,570.88 | $6,025.60 |
Martin's Point Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $3,548.13 | Professional | None | $2,691.53 | $3,548.13 | $3,548.13 |
United Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,511.89 | Facility | None | $2,454.71 | $2,454.71 | $2,511.89 |
United Setting Professional Modifier None Typical Low $2,041.74 Median $2,630.27 Typical High $7,244.36 | Professional | None | $2,041.74 | $2,630.27 | $7,244.36 |
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 $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,479.11 | $1,778.28 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $588.84 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $446.68 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $295.12 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,479.11 Median $1,778.28 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,479.11 | $1,778.28 | $1,778.28 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $588.84 Median $707.95 Typical High $707.95 | Professional | 53 · Discontinued | $588.84 | $707.95 | $707.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $446.68 Median $524.81 Typical High $524.81 | Professional | 55 · Aftercare only | $446.68 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $295.12 Median $354.81 Typical High $354.81 | Professional | 56 · Pre-op care only | $295.12 | $354.81 | $354.81 |
Where Maine sits
The same service costs 2.8 times more in Wyoming 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· 31st of 51
$2,754
WY $5,754DE $2,042
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.