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 $416.87 Median $467.74 Typical High $467.74 | Professional | None | $416.87 | $467.74 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $676.08 Median $870.96 Typical High $1,659.59 | Facility | None | $676.08 | $870.96 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | None | $416.87 | $416.87 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $46.77 | Professional | RR · Rental | $41.69 | $41.69 | $46.77 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $316.23 Median $316.23 Typical High $346.74 | Professional | UE · Used equipment | $316.23 | $316.23 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Facility | None | $436.52 | $436.52 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $436.52 | Professional | None | $316.23 | $316.23 | $436.52 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $288.40 Median $602.56 Typical High $794.33 | Professional | None | $288.40 | $602.56 | $794.33 |
Martin's Point Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $467.74 | Professional | None | $416.87 | $467.74 | $467.74 |
United Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $346.74 | Facility | None | $257.04 | $257.04 | $346.74 |
United Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $954.99 | Professional | None | $269.15 | $346.74 | $954.99 |
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 $223.87 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $46.77 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $223.87 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $89.13 | $93.33 | $93.33 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $66.07 | $69.18 | $69.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $46.77 |
Where Maine sits
The same service costs 2.8 times more in Montana than in Florida. 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· 26th of 51
$437
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.