How much rates vary
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 $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Facility | None | $812.83 | $1,047.13 | $1,995.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $426.58 | Professional | None | $389.05 | $389.05 | $426.58 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | RR · Rental | $38.90 | $38.90 | $42.66 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $295.12 Median $295.12 Typical High $323.59 | Professional | UE · Used equipment | $295.12 | $295.12 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $602.56 | Facility | None | $398.11 | $398.11 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $398.11 | Professional | None | $295.12 | $295.12 | $398.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $323.59 Median $724.44 Typical High $933.25 | Professional | None | $323.59 | $724.44 | $933.25 |
Martin's Point Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $549.54 | Professional | None | $407.38 | $549.54 | $549.54 |
United Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $1,148.15 | Professional | None | $323.59 | $407.38 | $1,148.15 |
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 $204.17 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $109.65 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $204.17 Median $275.42 Typical High $275.42 | Professional | 52 · Reduced service | $204.17 | $275.42 | $275.42 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $109.65 | Professional | 53 · Discontinued | $81.28 | $109.65 | $109.65 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $83.18 Typical High $83.18 | Professional | 55 · Aftercare only | $60.26 | $83.18 | $83.18 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $54.95 |
Where Maine sits
The same service costs 2.8 times more in Wisconsin 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· 34th of 51
$407
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.