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 $380.19 Median $562.34 Typical High $562.34 | Professional | None | $380.19 | $562.34 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Facility | None | $812.83 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $457.09 | Professional | None | $354.81 | $416.87 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | RR · Rental | $41.69 | $41.69 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | UE · Used equipment | $309.03 | $309.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $616.60 | Facility | None | $426.58 | $426.58 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $426.58 | Professional | None | $309.03 | $309.03 | $426.58 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $954.99 | Professional | None | $323.59 | $724.44 | $954.99 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $562.34 Typical High $562.34 | Professional | None | $380.19 | $562.34 | $562.34 |
United Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $457.09 | Facility | None | $426.58 | $426.58 | $457.09 |
United Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $1,148.15 | Professional | None | $323.59 | $416.87 | $1,148.15 |
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 $204.17 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $281.84 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $281.84 Typical High $281.84 | Professional | 52 · Reduced service | $204.17 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $112.20 Typical High $112.20 | Professional | 53 · Discontinued | $81.28 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $56.23 Typical High $56.23 | Professional | 56 · Pre-op care only | $40.74 | $56.23 | $56.23 |
Where Maine sits
The same service costs 3.8 times more in Hawaii 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
$427
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.