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 $125.89 Median $144.54 Typical High $144.54 | Professional | None | $125.89 | $144.54 | $144.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $524.81 | Facility | None | $213.80 | $275.42 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | None | $107.15 | $125.89 | $141.25 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.59 Median $12.59 Typical High $14.13 | Professional | RR · Rental | $12.59 | $12.59 | $14.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | UE · Used equipment | $95.50 | $95.50 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $165.96 Typical High $165.96 | Facility | None | $151.36 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $165.96 | Professional | None | $120.23 | $120.23 | $165.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $245.47 | Professional | None | $87.10 | $190.55 | $245.47 |
Martin's Point Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $144.54 | Professional | None | $125.89 | $144.54 | $144.54 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $141.25 | Facility | None | $138.04 | $138.04 | $141.25 |
United Setting Professional Modifier None Typical Low $85.11 Median $107.15 Typical High $302.00 | Professional | None | $85.11 | $107.15 | $302.00 |
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 $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $63.10 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $14.45 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $63.10 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $25.12 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $21.88 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $21.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $14.45 |
Where Maine sits
The same service costs 2.8 times more in Hawaii 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· 30th of 51
$132
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.