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 $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,949.84 | Facility | None | $794.33 | $1,023.29 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $501.19 | Professional | None | $457.09 | $457.09 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $45.71 Median $45.71 Typical High $50.12 | Professional | RR · Rental | $45.71 | $45.71 | $50.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $346.74 Median $346.74 Typical High $380.19 | Professional | UE · Used equipment | $346.74 | $346.74 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $645.65 Typical High $645.65 | Facility | None | $562.34 | $645.65 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $645.65 | Professional | None | $467.74 | $467.74 | $645.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $316.23 Median $707.95 Typical High $933.25 | Professional | None | $316.23 | $707.95 | $933.25 |
Martin's Point Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $549.54 | Professional | None | $446.68 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
United Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $1,122.02 | Professional | None | $316.23 | $398.11 | $1,122.02 |
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 $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $223.87 | $269.15 | $269.15 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $91.20 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $54.95 |
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· 29th of 51
$501
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.