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 $128.82 Median $162.18 Typical High $162.18 | Professional | None | $128.82 | $162.18 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $575.44 | Facility | None | $239.88 | $302.00 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $194.98 | Professional | None | $181.97 | $181.97 | $194.98 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $18.20 Typical High $19.95 | Professional | RR · Rental | $18.20 | $18.20 | $19.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $134.90 Median $134.90 Typical High $147.91 | Professional | UE · Used equipment | $134.90 | $134.90 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $177.83 | Facility | None | $169.82 | $169.82 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $169.82 | Professional | None | $125.89 | $125.89 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $208.93 Typical High $275.42 | Professional | None | $100.00 | $208.93 | $275.42 |
Martin's Point Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $162.18 | Professional | None | $128.82 | $162.18 | $162.18 |
United Setting Facility Modifier None Typical Low $112.20 Median $125.89 Typical High $134.90 | Facility | None | $112.20 | $125.89 | $134.90 |
United Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $331.13 | Professional | None | $93.33 | $120.23 | $331.13 |
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 $72.44 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $16.22 | $16.22 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $81.28 Typical High $81.28 | Professional | 52 · Reduced service | $72.44 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $28.84 | $32.36 | $32.36 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $24.55 Typical High $24.55 | Professional | 55 · Aftercare only | $21.88 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.22 Typical High $16.22 | Professional | 56 · Pre-op care only | $14.45 | $16.22 | $16.22 |
Where Maine sits
The same service costs 2.7 times more in Kansas 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
$182
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.