How much rates vary
Facilitymedian $8,710 · 10th to 90th $5,012 to $16,982Professionalmedian $4,266 · 10th to 90th $3,388 to $6,166
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 $4,466.84 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,786.30 | $4,786.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $7,079.46 Median $8,912.51 Typical High $16,982.44 | Facility | None | $7,079.46 | $8,912.51 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,677.35 | Professional | None | $4,265.80 | $4,265.80 | $4,677.35 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $426.58 Median $426.58 Typical High $467.74 | Professional | RR · Rental | $426.58 | $426.58 | $467.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3,235.94 Median $3,235.94 Typical High $3,548.13 | Professional | UE · Used equipment | $3,235.94 | $3,235.94 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $5,248.07 | Facility | None | $4,677.35 | $4,677.35 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,677.35 | Professional | None | $3,467.37 | $3,467.37 | $4,677.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2,951.21 Median $6,165.95 Typical High $8,128.31 | Professional | None | $2,951.21 | $6,165.95 | $8,128.31 |
Martin's Point Setting Professional Modifier None Typical Low $4,466.84 Median $4,786.30 Typical High $4,786.30 | Professional | None | $4,466.84 | $4,786.30 | $4,786.30 |
United Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Facility | None | $2,884.03 | $2,884.03 | $3,548.13 |
United Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $9,772.37 | Professional | None | $2,754.23 | $3,548.13 | $9,772.37 |
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 $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,238.72 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $891.25 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $660.69 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $446.68 | $478.63 | $478.63 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $2,238.72 Median $2,398.83 Typical High $2,398.83 | Professional | 52 · Reduced service | $2,238.72 | $2,398.83 | $2,398.83 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | 53 · Discontinued | $891.25 | $954.99 | $954.99 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $660.69 Median $724.44 Typical High $724.44 | Professional | 55 · Aftercare only | $660.69 | $724.44 | $724.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $446.68 Median $478.63 Typical High $478.63 | Professional | 56 · Pre-op care only | $446.68 | $478.63 | $478.63 |
Where Maine sits
The same service costs 2.3 times more in Arkansas than in Vermont. 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
$4,677
AR $8,128VT $3,467
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.