How much rates vary
Facilitymedian $13,183 · 10th to 90th $7,413 to $25,704Professionalmedian $5,623 · 10th to 90th $5,012 to $9,333
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 $5,248.07 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,248.07 | $7,244.36 | $7,244.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,471.29 Median $13,489.63 Typical High $25,703.96 | Facility | None | $10,471.29 | $13,489.63 | $25,703.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,165.95 | Professional | None | $5,623.41 | $5,623.41 | $6,165.95 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $562.34 Median $562.34 Typical High $616.60 | Professional | RR · Rental | $562.34 | $562.34 | $616.60 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | UE · Used equipment | $4,265.80 | $4,265.80 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,244.36 Typical High $7,762.47 | Facility | None | $7,244.36 | $7,244.36 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $5,248.07 Median $5,248.07 Typical High $7,244.36 | Professional | None | $5,248.07 | $5,248.07 | $7,244.36 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,168.69 Median $9,332.54 Typical High $12,302.69 | Professional | None | $4,168.69 | $9,332.54 | $12,302.69 |
Martin's Point Setting Professional Modifier None Typical Low $5,248.07 Median $7,244.36 Typical High $7,244.36 | Professional | None | $5,248.07 | $7,244.36 | $7,244.36 |
United Setting Facility Modifier None Typical Low $4,365.16 Median $4,365.16 Typical High $5,128.61 | Facility | None | $4,365.16 | $4,365.16 | $5,128.61 |
United Setting Professional Modifier None Typical Low $4,168.69 Median $5,370.32 Typical High $14,791.08 | Professional | None | $4,168.69 | $5,370.32 | $14,791.08 |
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 $2,754.23 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $2,754.23 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $1,122.02 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $831.76 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $549.54 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2,754.23 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $2,754.23 | $3,548.13 | $3,548.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,445.44 Typical High $1,445.44 | Professional | 53 · Discontinued | $1,122.02 | $1,445.44 | $1,445.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $831.76 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $831.76 | $1,071.52 | $1,071.52 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $549.54 Median $724.44 Typical High $724.44 | Professional | 56 · Pre-op care only | $549.54 | $724.44 | $724.44 |
Where Maine sits
The same service costs 2.1 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· 30th of 51
$5,888
HI $11,220NJ $5,248
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.