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 $117.49 Median $151.36 Typical High $151.36 | Professional | None | $117.49 | $151.36 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $288.40 Typical High $537.03 | Facility | None | $223.87 | $288.40 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $123.03 Typical High $134.90 | Professional | None | $104.71 | $123.03 | $134.90 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | RR · Rental | $12.30 | $12.30 | $13.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $93.33 Median $93.33 Typical High $102.33 | Professional | UE · Used equipment | $93.33 | $93.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $169.82 Typical High $169.82 | Facility | None | $158.49 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $169.82 | Professional | None | $123.03 | $123.03 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $89.13 Median $199.53 Typical High $257.04 | Professional | None | $89.13 | $199.53 | $257.04 |
Martin's Point Setting Professional Modifier None Typical Low $109.65 Median $151.36 Typical High $151.36 | Professional | None | $109.65 | $151.36 | $151.36 |
United Setting Facility Modifier None Typical Low $107.15 Median $107.15 Typical High $134.90 | Facility | None | $107.15 | $107.15 | $134.90 |
United Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $309.03 | Professional | None | $89.13 | $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 $61.66 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $30.20 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $61.66 Median $75.86 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $30.20 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $30.20 | $30.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $22.91 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $15.14 | $15.14 |
Where Maine sits
The same service costs 2.7 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· 35th of 51
$129
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.