How much rates vary
Facilitymedian $4,786 · 10th to 90th $2,754 to $9,333Professionalmedian $2,188 · 10th to 90th $1,585 to $3,388
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 $1,949.84 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,630.27 | $2,630.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,801.89 Median $4,897.79 Typical High $9,332.54 | Facility | None | $3,801.89 | $4,897.79 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,137.96 Median $2,187.76 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,187.76 | $2,344.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $213.80 Median $213.80 Typical High $234.42 | Professional | RR · Rental | $213.80 | $213.80 | $234.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,621.81 Median $1,621.81 Typical High $1,778.28 | Professional | UE · Used equipment | $1,621.81 | $1,621.81 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,884.03 | Facility | None | $2,137.96 | $2,137.96 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,584.89 | $1,584.89 | $2,137.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,513.56 Median $3,388.44 Typical High $4,466.84 | Professional | None | $1,513.56 | $3,388.44 | $4,466.84 |
Martin's Point Setting Professional Modifier None Typical Low $1,949.84 Median $2,630.27 Typical High $2,630.27 | Professional | None | $1,949.84 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,949.84 | $1,949.84 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $5,370.32 | Professional | None | $1,513.56 | $1,949.84 | $5,370.32 |
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 $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,047.13 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $309.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,047.13 Median $1,318.26 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,047.13 | $1,318.26 | $1,318.26 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $524.81 Typical High $524.81 | Professional | 53 · Discontinued | $416.87 | $524.81 | $524.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $389.05 Typical High $389.05 | Professional | 55 · Aftercare only | $309.03 | $389.05 | $389.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $263.03 Typical High $263.03 | Professional | 56 · Pre-op care only | $208.93 | $263.03 | $263.03 |
Where Maine sits
The same service costs 2.6 times more in Wisconsin 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
$2,188
WI $4,074DE $1,585
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.