How much rates vary
Facilitymedian $12,882 · 10th to 90th $7,586 to $25,119Professionalmedian $6,607 · 10th to 90th $4,898 to $9,120
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 $5,495.41 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,495.41 | $6,918.31 | $6,918.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $10,232.93 Median $13,182.57 Typical High $25,118.86 | Facility | None | $10,232.93 | $13,182.57 | $25,118.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $7,244.36 | Professional | None | $6,606.93 | $6,606.93 | $7,244.36 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $660.69 Median $660.69 Typical High $724.44 | Professional | RR · Rental | $660.69 | $660.69 | $724.44 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4,897.79 Median $4,897.79 Typical High $5,370.32 | Professional | UE · Used equipment | $4,897.79 | $4,897.79 | $5,370.32 |
Cigna Setting Facility Modifier None Typical Low $7,244.36 Median $7,585.78 Typical High $7,585.78 | Facility | None | $7,244.36 | $7,585.78 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $7,585.78 | Professional | None | $5,495.41 | $5,495.41 | $7,585.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4,073.80 Median $9,120.11 Typical High $12,022.64 | Professional | None | $4,073.80 | $9,120.11 | $12,022.64 |
Martin's Point Setting Professional Modifier None Typical Low $5,495.41 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,495.41 | $6,918.31 | $6,918.31 |
United Setting Facility Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,786.30 | Facility | None | $4,265.80 | $4,265.80 | $4,786.30 |
United Setting Professional Modifier None Typical Low $4,073.80 Median $5,128.61 Typical High $14,454.40 | Professional | None | $4,073.80 | $5,128.61 | $14,454.40 |
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 $2,818.38 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $2,818.38 | $3,467.37 | $3,467.37 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $1,122.02 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $851.14 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $562.34 | $691.83 | $691.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2,818.38 Median $3,467.37 Typical High $3,467.37 | Professional | 52 · Reduced service | $2,818.38 | $3,467.37 | $3,467.37 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1,122.02 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $1,122.02 | $1,412.54 | $1,412.54 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $851.14 Median $1,047.13 Typical High $1,047.13 | Professional | 55 · Aftercare only | $851.14 | $1,047.13 | $1,047.13 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $562.34 Median $691.83 Typical High $691.83 | Professional | 56 · Pre-op care only | $562.34 | $691.83 | $691.83 |
Where Maine sits
The same service costs 2.1 times more in Montana than in Pennsylvania. 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· 25th of 51
$6,761
MT $11,220PA $5,370
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.