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 $165.96 Median $190.55 Typical High $190.55 | Professional | None | $165.96 | $190.55 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $281.84 Median $354.81 Typical High $676.08 | Facility | None | $281.84 | $354.81 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $186.21 | Professional | None | $169.82 | $169.82 | $186.21 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $16.98 Median $16.98 Typical High $18.62 | Professional | RR · Rental | $16.98 | $16.98 | $18.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $125.89 Median $125.89 Typical High $138.04 | Professional | UE · Used equipment | $125.89 | $125.89 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $208.93 | Facility | None | $177.83 | $177.83 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $177.83 | Professional | None | $128.82 | $128.82 | $177.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $245.47 Typical High $323.59 | Professional | None | $114.82 | $245.47 | $323.59 |
Martin's Point Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | None | $165.96 | $190.55 | $190.55 |
United Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $208.93 | Facility | None | $186.21 | $186.21 | $208.93 |
United Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $389.05 | Professional | None | $109.65 | $141.25 | $389.05 |
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 $87.10 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $35.48 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $95.50 Typical High $95.50 | Professional | 52 · Reduced service | $87.10 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $38.02 Typical High $38.02 | Professional | 53 · Discontinued | $35.48 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $28.84 Typical High $28.84 | Professional | 55 · Aftercare only | $26.30 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $19.05 Typical High $19.05 | Professional | 56 · Pre-op care only | $17.38 | $19.05 | $19.05 |
Where Maine sits
The same service costs 3.5 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· 35th of 51
$174
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.