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 $380.19 Median $457.09 Typical High $457.09 | Professional | None | $380.19 | $457.09 | $457.09 |
Anthem BCBS Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $1,621.81 | Facility | None | $660.69 | $851.14 | $1,621.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $457.09 | Professional | None | $407.38 | $407.38 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $40.74 Median $40.74 Typical High $45.71 | Professional | RR · Rental | $40.74 | $40.74 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | UE · Used equipment | $309.03 | $309.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $524.81 | Facility | None | $467.74 | $524.81 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $524.81 | Professional | None | $389.05 | $389.05 | $524.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $263.03 Median $588.84 Typical High $776.25 | Professional | None | $263.03 | $588.84 | $776.25 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $457.09 | Professional | None | $380.19 | $457.09 | $457.09 |
United Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $380.19 | Facility | None | $302.00 | $302.00 | $380.19 |
United Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $933.25 | Professional | None | $263.03 | $338.84 | $933.25 |
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 $194.98 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $91.20 | $91.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $38.90 | $45.71 | $45.71 |
Where Maine sits
The same service costs 2.3 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· 29th of 51
$427
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.