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 $43.65 Median $61.66 Typical High $61.66 | Professional | None | $43.65 | $61.66 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $218.78 | Facility | None | $91.20 | $117.49 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $53.70 Typical High $57.54 | Professional | None | $52.48 | $53.70 | $57.54 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.25 Median $5.25 Typical High $5.75 | Professional | RR · Rental | $5.25 | $5.25 | $5.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $38.90 Median $38.90 Typical High $43.65 | Professional | UE · Used equipment | $38.90 | $38.90 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $51.29 Typical High $67.61 | Facility | None | $51.29 | $51.29 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $51.29 | Professional | None | $38.02 | $38.02 | $51.29 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $81.28 Typical High $104.71 | Professional | None | $36.31 | $81.28 | $104.71 |
Martin's Point Setting Professional Modifier None Typical Low $43.65 Median $61.66 Typical High $61.66 | Professional | None | $43.65 | $61.66 | $61.66 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Facility | None | $53.70 | $53.70 | $64.57 |
United Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $128.82 | Professional | None | $36.31 | $45.71 | $128.82 |
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 $23.99 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $9.55 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $6.17 | $6.17 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $23.99 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $9.55 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.79 | $6.17 | $6.17 |
Where Maine sits
The same service costs 4.9 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· 27th of 51
$53.70
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.