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 $67.61 Median $83.18 Typical High $83.18 | Professional | None | $67.61 | $83.18 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $154.88 Typical High $295.12 | Facility | None | $123.03 | $154.88 | $295.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $363.08 | Professional | None | $251.19 | $331.13 | $363.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $28.18 Median $33.11 Typical High $36.31 | Professional | RR · Rental | $28.18 | $33.11 | $36.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $251.19 Typical High $269.15 | Professional | UE · Used equipment | $186.21 | $251.19 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $107.15 | Facility | None | $100.00 | $100.00 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $100.00 | Professional | None | $85.11 | $85.11 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $47.86 Median $107.15 Typical High $141.25 | Professional | None | $47.86 | $107.15 | $141.25 |
Martin's Point Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $83.18 | Professional | None | $67.61 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $47.86 Median $61.66 Typical High $169.82 | Professional | None | $47.86 | $61.66 | $169.82 |
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 $33.88 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $41.69 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $13.49 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.76 | $8.32 | $8.32 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.88 Median $41.69 Typical High $41.69 | Professional | 52 · Reduced service | $33.88 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.60 Typical High $16.60 | Professional | 53 · Discontinued | $13.49 | $16.60 | $16.60 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $10.23 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.32 Typical High $8.32 | Professional | 56 · Pre-op care only | $6.76 | $8.32 | $8.32 |
Where Maine sits
The same service costs 2.4 times more in Indiana than in Kentucky. 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· 9th of 51
$123
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.