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 $288.40 Median $363.08 Typical High $363.08 | Professional | None | $288.40 | $363.08 | $363.08 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $1,288.25 | Facility | None | $537.03 | $691.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | None | $295.12 | $295.12 | $323.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $29.51 Median $29.51 Typical High $32.36 | Professional | RR · Rental | $29.51 | $29.51 | $32.36 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $218.78 Median $218.78 Typical High $245.47 | Professional | UE · Used equipment | $218.78 | $218.78 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $398.11 | Facility | None | $363.08 | $363.08 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $363.08 | Professional | None | $269.15 | $269.15 | $363.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $616.60 | Professional | None | $213.80 | $478.63 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $363.08 | Professional | None | $288.40 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $323.59 | Facility | None | $239.88 | $239.88 | $323.59 |
United Setting Professional Modifier None Typical Low $213.80 Median $269.15 Typical High $758.58 | Professional | None | $213.80 | $269.15 | $758.58 |
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 $144.54 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $57.54 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $144.54 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $144.54 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $57.54 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $43.65 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $28.84 | $36.31 | $36.31 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in Alabama. 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· 29th of 51
$324
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.