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 Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $30.20 Typical High $30.20 | Professional | None | $19.50 | $30.20 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $107.15 | Facility | None | $43.65 | $56.23 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $32.36 Median $34.67 Typical High $40.74 | Professional | None | $32.36 | $34.67 | $40.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | RR · Rental | $3.24 | $3.24 | $3.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $24.55 Median $24.55 Typical High $26.30 | Professional | UE · Used equipment | $24.55 | $24.55 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $31.62 Median $34.67 Typical High $34.67 | Facility | None | $31.62 | $34.67 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $34.67 | Professional | None | $25.70 | $25.70 | $34.67 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.20 Median $38.90 Typical High $51.29 | Professional | None | $18.20 | $38.90 | $51.29 |
Martin's Point Setting Professional Modifier None Typical Low $19.50 Median $30.20 Typical High $30.20 | Professional | None | $19.50 | $30.20 | $30.20 |
United Setting Facility Modifier None Typical Low $16.22 Median $29.51 Typical High $31.62 | Facility | None | $16.22 | $29.51 | $31.62 |
United Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $61.66 | Professional | None | $17.38 | $22.39 | $61.66 |
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 $13.18 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $6.03 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.98 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $3.02 | $3.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $13.18 Median $15.14 Typical High $15.14 | Professional | 52 · Reduced service | $13.18 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $6.03 Typical High $6.03 | Professional | 53 · Discontinued | $5.25 | $6.03 | $6.03 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $3.98 | $4.47 | $4.47 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $3.02 Typical High $3.02 | Professional | 56 · Pre-op care only | $2.63 | $3.02 | $3.02 |
Where Maine sits
The same service costs 3.2 times more in Hawaii than in Washington, DC. 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· 28th of 51
$32.36
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.