How much rates vary
Facilitymedian $4,898 · 10th to 90th $2,818 to $9,550Professionalmedian $1,995 · 10th to 90th $1,905 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 $1,819.70 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,819.70 | $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 $1,995.26 Median $1,995.26 Typical High $2,187.76 | Professional | None | $1,995.26 | $1,995.26 | $2,187.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $199.53 Median $199.53 Typical High $218.78 | Professional | RR · Rental | $199.53 | $199.53 | $218.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,513.56 Median $1,513.56 Typical High $1,659.59 | Professional | UE · Used equipment | $1,513.56 | $1,513.56 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,951.21 | Facility | None | $2,691.53 | $2,691.53 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $2,691.53 | Professional | None | $1,949.84 | $1,949.84 | $2,691.53 |
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 $1,819.70 Median $2,691.53 Typical High $2,691.53 | Professional | None | $1,819.70 | $2,691.53 | $2,691.53 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,187.76 | Facility | None | $1,862.09 | $1,862.09 | $2,187.76 |
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 $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $977.24 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $389.05 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $295.12 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $977.24 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $977.24 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $537.03 Typical High $537.03 | Professional | 53 · Discontinued | $389.05 | $537.03 | $537.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $407.38 Typical High $407.38 | Professional | 55 · Aftercare only | $295.12 | $407.38 | $407.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $194.98 | $269.15 | $269.15 |
Where Maine sits
The same service costs 2.9 times more in Hawaii 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· 28th of 51
$2,188
HI $5,012DC $1,738
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.