How much rates vary
Facilitymedian $4,365 · 10th to 90th $2,455 to $8,318Professionalmedian $2,089 · 10th to 90th $1,660 to $3,020
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 $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,344.23 | $2,344.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,467.37 Median $4,365.16 Typical High $8,317.64 | Facility | None | $3,467.37 | $4,365.16 | $8,317.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,089.30 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | RR · Rental | $208.93 | $208.93 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | UE · Used equipment | $1,548.82 | $1,548.82 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,570.40 | Facility | None | $2,398.83 | $2,398.83 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,737.80 | $1,737.80 | $2,398.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,412.54 Median $3,019.95 Typical High $3,981.07 | Professional | None | $1,412.54 | $3,019.95 | $3,981.07 |
Martin's Point Setting Professional Modifier None Typical Low $2,137.96 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,137.96 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,698.24 | Facility | None | $1,445.44 | $1,445.44 | $1,698.24 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,737.80 Typical High $4,786.30 | Professional | None | $1,348.96 | $1,737.80 | $4,786.30 |
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 $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,174.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $234.42 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1,071.52 Median $1,174.90 Typical High $1,174.90 | Professional | 52 · Reduced service | $1,071.52 | $1,174.90 | $1,174.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $467.74 Typical High $467.74 | Professional | 53 · Discontinued | $426.58 | $467.74 | $467.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | 55 · Aftercare only | $323.59 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | 56 · Pre-op care only | $213.80 | $234.42 | $234.42 |
Where Maine sits
The same service costs 2.2 times more in Arkansas than in Delaware. 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· 26th of 51
$2,291
AR $3,890DE $1,738
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.