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 $10.96 Median $14.45 Typical High $14.45 | Professional | None | $10.96 | $14.45 | $14.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.38 Median $26.92 Typical High $51.29 | Facility | None | $21.38 | $26.92 | $51.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.49 Median $14.13 Typical High $14.79 | Professional | None | $13.49 | $14.13 | $14.79 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $1.48 | Professional | RR · Rental | $1.35 | $1.35 | $1.48 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.23 Typical High $11.22 | Professional | UE · Used equipment | $10.23 | $10.23 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $15.85 | Facility | None | $14.45 | $14.45 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.32 Median $18.62 Typical High $24.55 | Professional | None | $8.32 | $18.62 | $24.55 |
Martin's Point Setting Professional Modifier None Typical Low $9.33 Median $14.45 Typical High $14.45 | Professional | None | $9.33 | $14.45 | $14.45 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $12.88 | Facility | None | $12.59 | $12.59 | $12.88 |
United Setting Professional Modifier None Typical Low $8.32 Median $10.72 Typical High $29.51 | Professional | None | $8.32 | $10.72 | $29.51 |
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 $5.62 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $5.62 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.29 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $1.70 | $2.19 | $2.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.12 | $1.45 | $1.45 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $7.24 Typical High $7.24 | Professional | 52 · Reduced service | $5.62 | $7.24 | $7.24 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.88 Typical High $2.88 | Professional | 53 · Discontinued | $2.29 | $2.88 | $2.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $2.19 Typical High $2.19 | Professional | 55 · Aftercare only | $1.70 | $2.19 | $2.19 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.12 | $1.45 | $1.45 |
Where Maine sits
The same service costs 3.0 times more in Hawaii 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· 24th of 51
$14.13
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.