How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,818 to $9,550Professionalmedian $1,950 · 10th to 90th $1,738 to $3,467
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 $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,691.53 | $2,691.53 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,981.07 Median $5,011.87 Typical High $9,549.93 | Facility | None | $3,981.07 | $5,011.87 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,137.96 | Professional | None | $1,949.84 | $1,949.84 | $2,137.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $194.98 Median $194.98 Typical High $213.80 | Professional | RR · Rental | $194.98 | $194.98 | $213.80 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,445.44 Median $1,445.44 Typical High $1,584.89 | Professional | UE · Used equipment | $1,445.44 | $1,445.44 | $1,584.89 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,951.21 | Facility | None | $2,454.71 | $2,454.71 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,819.70 | $1,819.70 | $2,454.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,548.82 Median $3,467.37 Typical High $4,570.88 | Professional | None | $1,548.82 | $3,467.37 | $4,570.88 |
Martin's Point Setting Professional Modifier None Typical Low $1,905.46 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,691.53 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,949.84 | Facility | None | $1,698.24 | $1,698.24 | $1,949.84 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $1,995.26 Typical High $5,495.41 | Professional | None | $1,548.82 | $1,995.26 | $5,495.41 |
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 $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $954.99 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $288.40 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $954.99 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $954.99 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $380.19 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $288.40 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $190.55 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $190.55 | $269.15 | $269.15 |
Where Maine sits
The same service costs 2.4 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· 28th of 51
$2,138
HI $4,365DE $1,820
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.