How much rates vary
Facilitymedian $25,119 · 10th to 90th $14,125 to $47,863Professionalmedian $10,715 · 10th to 90th $9,120 to $17,378
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 $10,471.29 Median $13,489.63 Typical High $13,489.63 | Professional | None | $10,471.29 | $13,489.63 | $13,489.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $19,952.62 Median $25,118.86 Typical High $47,863.01 | Facility | None | $19,952.62 | $25,118.86 | $47,863.01 |
Anthem BCBS Setting Professional Modifier None Typical Low $10,715.19 Median $10,715.19 Typical High $11,748.98 | Professional | None | $10,715.19 | $10,715.19 | $11,748.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1,071.52 Median $1,071.52 Typical High $1,174.90 | Professional | RR · Rental | $1,071.52 | $1,071.52 | $1,174.90 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7,943.28 Median $7,943.28 Typical High $8,912.51 | Professional | UE · Used equipment | $7,943.28 | $7,943.28 | $8,912.51 |
Cigna Setting Facility Modifier None Typical Low $12,589.25 Median $12,589.25 Typical High $14,791.08 | Facility | None | $12,589.25 | $12,589.25 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $9,120.11 Median $9,120.11 Typical High $12,589.25 | Professional | None | $9,120.11 | $9,120.11 | $12,589.25 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7,762.47 Median $17,378.01 Typical High $22,908.68 | Professional | None | $7,762.47 | $17,378.01 | $22,908.68 |
Martin's Point Setting Professional Modifier None Typical Low $10,471.29 Median $13,489.63 Typical High $13,489.63 | Professional | None | $10,471.29 | $13,489.63 | $13,489.63 |
United Setting Facility Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $9,332.54 | Facility | None | $7,943.28 | $7,943.28 | $9,332.54 |
United Setting Professional Modifier None Typical Low $7,762.47 Median $10,000.00 Typical High $27,542.29 | Professional | None | $7,762.47 | $10,000.00 | $27,542.29 |
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 $5,495.41 Median $6,760.83 Typical High $6,760.83 | Professional | 52 · Reduced service | $5,495.41 | $6,760.83 | $6,760.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2,187.76 Median $2,691.53 Typical High $2,691.53 | Professional | 53 · Discontinued | $2,187.76 | $2,691.53 | $2,691.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | 55 · Aftercare only | $1,621.81 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $1,096.48 | $1,348.96 | $1,348.96 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5,495.41 Median $6,760.83 Typical High $6,760.83 | Professional | 52 · Reduced service | $5,495.41 | $6,760.83 | $6,760.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2,187.76 Median $2,691.53 Typical High $2,691.53 | Professional | 53 · Discontinued | $2,187.76 | $2,691.53 | $2,691.53 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1,621.81 Median $2,041.74 Typical High $2,041.74 | Professional | 55 · Aftercare only | $1,621.81 | $2,041.74 | $2,041.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1,096.48 Median $1,348.96 Typical High $1,348.96 | Professional | 56 · Pre-op care only | $1,096.48 | $1,348.96 | $1,348.96 |
Where Maine sits
The same service costs 2.5 times more in Montana than in Florida. 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· 32nd of 51
$10,965
MT $22,387FL $9,120
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.