How much rates vary
Facilitymedian $6,026 · 10th to 90th $3,631 to $11,749Professionalmedian $2,818 · 10th to 90th $2,344 to $4,266
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 $2,884.03 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,884.03 | $3,311.31 | $3,311.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $4,897.79 Median $6,165.95 Typical High $11,748.98 | Facility | None | $4,897.79 | $6,165.95 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,090.30 | Professional | None | $2,818.38 | $2,818.38 | $3,090.30 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $281.84 Median $281.84 Typical High $309.03 | Professional | RR · Rental | $281.84 | $281.84 | $309.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | UE · Used equipment | $2,089.30 | $2,089.30 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $3,467.37 Median $3,548.13 Typical High $3,630.78 | Facility | None | $3,467.37 | $3,548.13 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $3,548.13 | Professional | None | $2,570.40 | $2,570.40 | $3,548.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,905.46 Median $4,265.80 Typical High $5,623.41 | Professional | None | $1,905.46 | $4,265.80 | $5,623.41 |
Martin's Point Setting Professional Modifier None Typical Low $2,884.03 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,884.03 | $3,311.31 | $3,311.31 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,019.95 Typical High $3,890.45 | Facility | None | $3,019.95 | $3,019.95 | $3,890.45 |
United Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $6,760.83 | Professional | None | $1,905.46 | $2,454.71 | $6,760.83 |
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 $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,445.44 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $575.44 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $436.52 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $288.40 | $331.13 | $331.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,445.44 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $1,445.44 | $1,659.59 | $1,659.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | 53 · Discontinued | $575.44 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $436.52 | $501.19 | $501.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $288.40 | $331.13 | $331.13 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in Pennsylvania. 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· 27th of 51
$3,090
HI $7,413PA $2,455
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.