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 $45.71 Median $60.26 Typical High $60.26 | Professional | None | $45.71 | $60.26 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $112.20 Typical High $213.80 | Facility | None | $87.10 | $112.20 | $213.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $60.26 | Professional | None | $46.77 | $54.95 | $60.26 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $6.03 | Professional | RR · Rental | $5.50 | $5.50 | $6.03 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $40.74 Median $40.74 Typical High $44.67 | Professional | UE · Used equipment | $40.74 | $40.74 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $50.12 | Professional | None | $37.15 | $37.15 | $50.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $34.67 Median $77.62 Typical High $102.33 | Professional | None | $34.67 | $77.62 | $102.33 |
Martin's Point Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $60.26 | Professional | None | $45.71 | $60.26 | $60.26 |
United Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
United Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $123.03 | Professional | None | $34.67 | $43.65 | $123.03 |
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 $24.55 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $24.55 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $6.03 | $6.03 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $29.51 Typical High $29.51 | Professional | 52 · Reduced service | $24.55 | $29.51 | $29.51 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.02 Typical High $12.02 | Professional | 53 · Discontinued | $9.77 | $12.02 | $12.02 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $8.91 Typical High $8.91 | Professional | 55 · Aftercare only | $7.24 | $8.91 | $8.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.03 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.90 | $6.03 | $6.03 |
Where Maine sits
The same service costs 2.8 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· 27th of 51
$56.23
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.