How much rates vary
Facilitymedian $56,234 · 10th to 90th $33,113 to $107,152Professionalmedian $23,988 · 10th to 90th $21,380 to $39,811
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 $23,442.29 Median $30,199.52 Typical High $30,199.52 | Professional | None | $23,442.29 | $30,199.52 | $30,199.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $44,668.36 Median $57,543.99 Typical High $107,151.93 | Facility | None | $44,668.36 | $57,543.99 | $107,151.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $23,988.33 Median $23,988.33 Typical High $26,302.68 | Professional | None | $23,988.33 | $23,988.33 | $26,302.68 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2,398.83 Median $2,398.83 Typical High $2,630.27 | Professional | RR · Rental | $2,398.83 | $2,398.83 | $2,630.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $17,782.79 Median $17,782.79 Typical High $19,952.62 | Professional | UE · Used equipment | $17,782.79 | $17,782.79 | $19,952.62 |
Cigna Setting Facility Modifier None Typical Low $30,199.52 Median $30,199.52 Typical High $33,113.11 | Facility | None | $30,199.52 | $30,199.52 | $33,113.11 |
Cigna Setting Professional Modifier None Typical Low $22,387.21 Median $22,387.21 Typical High $30,199.52 | Professional | None | $22,387.21 | $22,387.21 | $30,199.52 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $17,782.79 Median $39,810.72 Typical High $51,286.14 | Professional | None | $17,782.79 | $39,810.72 | $51,286.14 |
Martin's Point Setting Professional Modifier None Typical Low $23,442.29 Median $30,199.52 Typical High $30,199.52 | Professional | None | $23,442.29 | $30,199.52 | $30,199.52 |
United Setting Professional Modifier None Typical Low $17,782.79 Median $22,387.21 Typical High $63,095.73 | Professional | None | $17,782.79 | $22,387.21 | $63,095.73 |
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 $11,748.98 Median $15,135.61 Typical High $15,135.61 | Professional | 52 · Reduced service | $11,748.98 | $15,135.61 | $15,135.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4,677.35 Median $6,025.60 Typical High $6,025.60 | Professional | 53 · Discontinued | $4,677.35 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3,548.13 Median $4,570.88 Typical High $4,570.88 | Professional | 55 · Aftercare only | $3,548.13 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | 56 · Pre-op care only | $2,344.23 | $3,019.95 | $3,019.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11,748.98 Median $15,135.61 Typical High $15,135.61 | Professional | 52 · Reduced service | $11,748.98 | $15,135.61 | $15,135.61 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4,677.35 Median $6,025.60 Typical High $6,025.60 | Professional | 53 · Discontinued | $4,677.35 | $6,025.60 | $6,025.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3,548.13 Median $4,570.88 Typical High $4,570.88 | Professional | 55 · Aftercare only | $3,548.13 | $4,570.88 | $4,570.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2,344.23 Median $3,019.95 Typical High $3,019.95 | Professional | 56 · Pre-op care only | $2,344.23 | $3,019.95 | $3,019.95 |
Where Maine sits
The same service costs 2.1 times more in Hawaii than in New Jersey. 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· 30th of 51
$26,303
HI $47,863NJ $22,387
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.