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 $436.52 Median $588.84 Typical High $588.84 | Professional | None | $436.52 | $588.84 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $851.14 Median $1,096.48 Typical High $2,089.30 | Facility | None | $851.14 | $1,096.48 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $549.54 | Professional | None | $501.19 | $501.19 | $549.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | RR · Rental | $50.12 | $50.12 | $54.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $380.19 Median $380.19 Typical High $416.87 | Professional | UE · Used equipment | $380.19 | $380.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $691.83 Typical High $691.83 | Facility | None | $602.56 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $691.83 | Professional | None | $512.86 | $512.86 | $691.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $346.74 Median $758.58 Typical High $1,000.00 | Professional | None | $346.74 | $758.58 | $1,000.00 |
Martin's Point Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $588.84 | Professional | None | $436.52 | $588.84 | $588.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Facility | None | $398.11 | $398.11 | $501.19 |
United Setting Professional Modifier None Typical Low $338.84 Median $436.52 Typical High $1,202.26 | Professional | None | $338.84 | $436.52 | $1,202.26 |
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 $245.47 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $58.88 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $245.47 Median $295.12 Typical High $295.12 | Professional | 52 · Reduced service | $245.47 | $295.12 | $295.12 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $117.49 | $117.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $87.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $58.88 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $58.88 | $58.88 |
Where Maine sits
The same service costs 2.4 times more in Hawaii than in Washington, DC. 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· 28th of 51
$550
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.