How much rates vary
Facilitymedian $2,399 · 10th to 90th $1,349 to $4,677Professionalmedian $1,175 · 10th to 90th $912 to $1,698
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 $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,318.26 | $1,318.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $4,677.35 | Facility | None | $1,905.46 | $2,454.71 | $4,677.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | None | $1,174.90 | $1,174.90 | $1,318.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $117.49 Median $117.49 Typical High $131.83 | Professional | RR · Rental | $117.49 | $117.49 | $131.83 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $891.25 Median $891.25 Typical High $977.24 | Professional | UE · Used equipment | $891.25 | $891.25 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,412.54 | Facility | None | $1,258.93 | $1,258.93 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,258.93 | Professional | None | $912.01 | $912.01 | $1,258.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $812.83 Median $1,698.24 Typical High $2,238.72 | Professional | None | $812.83 | $1,698.24 | $2,238.72 |
Martin's Point Setting Professional Modifier None Typical Low $1,230.27 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,318.26 | $1,318.26 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $977.24 | Facility | None | $691.83 | $691.83 | $977.24 |
United Setting Professional Modifier None Typical Low $758.58 Median $977.24 Typical High $2,691.53 | Professional | None | $758.58 | $977.24 | $2,691.53 |
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 $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $131.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $616.60 | $660.69 | $660.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $245.47 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $245.47 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | 55 · Aftercare only | $181.97 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $131.83 | $131.83 |
Where Maine sits
The same service costs 2.5 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· 23rd of 51
$1,259
AR $2,239DE $912
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.