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 $457.09 Median $524.81 Typical High $524.81 | Professional | None | $457.09 | $524.81 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $977.24 Typical High $1,862.09 | Facility | None | $776.25 | $977.24 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $478.63 Typical High $512.86 | Professional | None | $457.09 | $478.63 | $512.86 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $51.29 | Professional | RR · Rental | $45.71 | $45.71 | $51.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | UE · Used equipment | $346.74 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $660.69 Typical High $660.69 | Facility | None | $549.54 | $660.69 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $660.69 | Professional | None | $489.78 | $489.78 | $660.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $676.08 Typical High $891.25 | Professional | None | $316.23 | $676.08 | $891.25 |
Martin's Point Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $524.81 | Professional | None | $457.09 | $524.81 | $524.81 |
United Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Facility | None | $501.19 | $501.19 | $549.54 |
United Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $1,071.52 | Professional | None | $302.00 | $389.05 | $1,071.52 |
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 $239.88 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $52.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $239.88 Median $263.03 Typical High $263.03 | Professional | 52 · Reduced service | $239.88 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $104.71 Typical High $104.71 | Professional | 53 · Discontinued | $95.50 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $72.44 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $52.48 Typical High $52.48 | Professional | 56 · Pre-op care only | $47.86 | $52.48 | $52.48 |
Where Maine sits
The same service costs 4.1 times more in Hawaii than in Kansas. 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· 37th of 51
$490
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.