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 $141.25 Median $151.36 Typical High $151.36 | Professional | None | $141.25 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $218.78 Median $281.84 Typical High $537.03 | Facility | None | $218.78 | $281.84 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $151.36 | Professional | None | $138.04 | $138.04 | $151.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $13.80 Median $13.80 Typical High $15.14 | Professional | RR · Rental | $13.80 | $13.80 | $15.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $102.33 Median $102.33 Typical High $112.20 | Professional | UE · Used equipment | $102.33 | $102.33 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $165.96 | Facility | None | $158.49 | $158.49 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $158.49 | Professional | None | $117.49 | $117.49 | $158.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $194.98 Typical High $257.04 | Professional | None | $93.33 | $194.98 | $257.04 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $151.36 | Professional | None | $141.25 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $131.83 | Facility | None | $107.15 | $107.15 | $131.83 |
United Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $309.03 | Professional | None | $87.10 | $112.20 | $309.03 |
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 $70.79 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $70.79 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $70.79 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $70.79 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $28.18 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $21.38 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $14.13 | $15.14 | $15.14 |
Where Maine sits
The same service costs 2.4 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· 27th of 51
$148
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.