How much rates vary
Facilitymedian $3,981 · 10th to 90th $2,239 to $7,762Professionalmedian $1,738 · 10th to 90th $1,288 to $2,818
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 $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,162.28 Median $4,073.80 Typical High $7,762.47 | Facility | None | $3,162.28 | $4,073.80 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,737.80 | $1,737.80 | $1,905.46 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $173.78 Median $173.78 Typical High $190.55 | Professional | RR · Rental | $173.78 | $173.78 | $190.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,318.26 Median $1,318.26 Typical High $1,445.44 | Professional | UE · Used equipment | $1,318.26 | $1,318.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,344.23 | Facility | None | $1,778.28 | $1,778.28 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,288.25 | $1,288.25 | $1,778.28 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,258.93 Median $2,818.38 Typical High $3,715.35 | Professional | None | $1,258.93 | $2,818.38 | $3,715.35 |
Martin's Point Setting Professional Modifier None Typical Low $1,698.24 Median $2,137.96 Typical High $2,137.96 | Professional | None | $1,698.24 | $2,137.96 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,862.09 | Facility | None | $1,621.81 | $1,621.81 | $1,862.09 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $4,466.84 | Professional | None | $1,258.93 | $1,584.89 | $4,466.84 |
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 $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $851.14 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $213.80 | $213.80 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $851.14 Median $1,071.52 Typical High $1,071.52 | Professional | 52 · Reduced service | $851.14 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $346.74 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $346.74 | $436.52 | $436.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $257.04 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $257.04 | $323.59 | $323.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $169.82 Median $213.80 Typical High $213.80 | Professional | 56 · Pre-op care only | $169.82 | $213.80 | $213.80 |
Where Maine sits
The same service costs 3.2 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· 32nd of 51
$1,778
HI $4,169DE $1,288
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.