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 $239.88 Median $371.54 Typical High $371.54 | Professional | None | $239.88 | $371.54 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $691.83 Typical High $1,318.26 | Facility | None | $549.54 | $691.83 | $1,318.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $275.42 | Professional | None | $251.19 | $251.19 | $275.42 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $25.12 Median $25.12 Typical High $27.54 | Professional | RR · Rental | $25.12 | $25.12 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $204.17 | Professional | UE · Used equipment | $186.21 | $186.21 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $407.38 | Facility | None | $275.42 | $275.42 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $478.63 Typical High $630.96 | Professional | None | $213.80 | $478.63 | $630.96 |
Martin's Point Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $371.54 | Professional | None | $239.88 | $371.54 | $371.54 |
United Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $275.42 | Facility | None | $218.78 | $218.78 | $275.42 |
United Setting Professional Modifier None Typical Low $208.93 Median $275.42 Typical High $758.58 | Professional | None | $208.93 | $275.42 | $758.58 |
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 $123.03 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $186.21 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $50.12 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $37.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $123.03 Median $186.21 Typical High $186.21 | Professional | 52 · Reduced service | $123.03 | $186.21 | $186.21 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $74.13 Typical High $74.13 | Professional | 53 · Discontinued | $50.12 | $74.13 | $74.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $37.15 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $37.15 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.12 | $37.15 | $37.15 |
Where Maine sits
The same service costs 2.9 times more in Hawaii 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· 33rd of 51
$263
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.