How much rates vary
Facilitymedian $3,162 · 10th to 90th $1,950 to $6,166Professionalmedian $1,445 · 10th to 90th $1,175 to $2,239
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 $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,511.89 Median $3,235.94 Typical High $6,165.95 | Facility | None | $2,511.89 | $3,235.94 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,548.82 | Professional | None | $1,174.90 | $1,380.38 | $1,548.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $138.04 Median $138.04 Typical High $154.88 | Professional | RR · Rental | $138.04 | $138.04 | $154.88 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,047.13 Median $1,047.13 Typical High $1,148.15 | Professional | UE · Used equipment | $1,047.13 | $1,047.13 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,949.84 Typical High $1,949.84 | Facility | None | $1,778.28 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,445.44 | $1,445.44 | $1,949.84 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,000.00 Median $2,238.72 Typical High $2,884.03 | Professional | None | $1,000.00 | $2,238.72 | $2,884.03 |
Martin's Point Setting Professional Modifier None Typical Low $1,348.96 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,348.96 | $1,698.24 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,258.93 | Facility | None | $1,096.48 | $1,096.48 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $3,548.13 | Professional | None | $1,000.00 | $1,258.93 | $3,548.13 |
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 $691.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $169.82 | $169.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $691.83 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $691.83 | $851.14 | $851.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $338.84 | $338.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $257.04 | $257.04 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $138.04 | $169.82 | $169.82 |
Where Maine sits
The same service costs 2.4 times more in Minnesota than in Washington, DC. 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· 36th of 51
$1,445
MN $2,951DC $1,230
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.