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 $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $263.03 Typical High $501.19 | Facility | None | $204.17 | $263.03 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $138.04 Typical High $151.36 | Professional | None | $117.49 | $138.04 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | RR · Rental | $13.80 | $13.80 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | UE · Used equipment | $102.33 | $102.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $173.78 Typical High $173.78 | Facility | None | $144.54 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $173.78 | Professional | None | $128.82 | $128.82 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $181.97 Typical High $239.88 | Professional | None | $87.10 | $181.97 | $239.88 |
Martin's Point Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $141.25 | Professional | None | $117.49 | $141.25 | $141.25 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $288.40 | Professional | None | $81.28 | $104.71 | $288.40 |
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 $63.10 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $63.10 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $25.12 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $18.62 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $14.13 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $63.10 | $70.79 | $70.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $25.12 | $28.18 | $28.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $18.62 | $20.89 | $20.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $14.13 | $14.13 |
Where Maine sits
The same service costs 2.0 times more in Wisconsin 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· 27th of 51
$141
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.