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 $1,230.27 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,584.89 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $2,951.21 Typical High $5,623.41 | Facility | None | $2,344.23 | $2,951.21 | $5,623.41 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,445.44 | $1,445.44 | $1,584.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $144.54 Median $144.54 Typical High $158.49 | Professional | RR · Rental | $144.54 | $144.54 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,096.48 Median $1,096.48 Typical High $1,202.26 | Professional | UE · Used equipment | $1,096.48 | $1,096.48 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,737.80 | Facility | None | $1,348.96 | $1,348.96 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,348.96 | Professional | None | $977.24 | $977.24 | $1,348.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $912.01 Median $2,041.74 Typical High $2,691.53 | Professional | None | $912.01 | $2,041.74 | $2,691.53 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,230.27 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $3,235.94 | Professional | None | $912.01 | $1,174.90 | $3,235.94 |
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 $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $645.65 Median $794.33 Typical High $794.33 | Professional | 52 · Reduced service | $645.65 | $794.33 | $794.33 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $257.04 Median $316.23 Typical High $316.23 | Professional | 53 · Discontinued | $257.04 | $316.23 | $316.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $239.88 Typical High $239.88 | Professional | 55 · Aftercare only | $194.98 | $239.88 | $239.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $158.49 Typical High $158.49 | Professional | 56 · Pre-op care only | $128.82 | $158.49 | $158.49 |
Where Maine sits
The same service costs 2.6 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· 27th of 51
$1,479
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.