How much rates vary
Facilitymedian $5,129 · 10th to 90th $2,951 to $10,000Professionalmedian $2,239 · 10th to 90th $1,995 to $3,631
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 $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,168.69 Median $5,248.07 Typical High $10,000.00 | Facility | None | $4,168.69 | $5,248.07 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,511.89 | Professional | None | $2,238.72 | $2,238.72 | $2,511.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $223.87 Median $223.87 Typical High $251.19 | Professional | RR · Rental | $223.87 | $223.87 | $251.19 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,698.24 Median $1,698.24 Typical High $1,862.09 | Professional | UE · Used equipment | $1,698.24 | $1,698.24 | $1,862.09 |
Cigna Setting Facility Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $3,090.30 | Facility | None | $2,951.21 | $2,951.21 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,951.21 | Professional | None | $2,187.76 | $2,187.76 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,621.81 Median $3,630.78 Typical High $4,786.30 | Professional | None | $1,621.81 | $3,630.78 | $4,786.30 |
Martin's Point Setting Professional Modifier None Typical Low $2,238.72 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,238.72 | $2,818.38 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,951.21 | Facility | None | $2,041.74 | $2,041.74 | $2,951.21 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $5,754.40 | Professional | None | $1,621.81 | $2,089.30 | $5,754.40 |
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 $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,202.26 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $478.63 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $239.88 | $281.84 | $281.84 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,202.26 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $1,202.26 | $1,412.54 | $1,412.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $478.63 Median $562.34 Typical High $562.34 | Professional | 53 · Discontinued | $478.63 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $363.08 | $426.58 | $426.58 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $239.88 Median $281.84 Typical High $281.84 | Professional | 56 · Pre-op care only | $239.88 | $281.84 | $281.84 |
Where Maine sits
The same service costs 2.5 times more in Montana 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
$2,512
MT $4,898DC $1,995
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.