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 $537.03 Typical High $537.03 | Professional | None | $380.19 | $537.03 | $537.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,905.46 | Facility | None | $776.25 | $1,000.00 | $1,905.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $467.74 | Professional | None | $363.08 | $426.58 | $467.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | RR · Rental | $42.66 | $42.66 | $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 $562.34 Median $562.34 Typical High $602.56 | Facility | None | $562.34 | $562.34 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $691.83 Typical High $912.01 | Professional | None | $309.03 | $691.83 | $912.01 |
Martin's Point Setting Professional Modifier None Typical Low $380.19 Median $537.03 Typical High $537.03 | Professional | None | $380.19 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $1,096.48 | Professional | None | $309.03 | $398.11 | $1,096.48 |
4 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 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $39.81 | $53.70 | $53.70 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $79.43 Typical High $79.43 | Professional | 55 · Aftercare only | $60.26 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $39.81 | $53.70 | $53.70 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in New Jersey. 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
$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.