How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $257.04 Median $363.08 Typical High $363.08 | Professional | None | $257.04 | $363.08 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $501.19 | Professional | None | $181.97 | $245.47 | $501.19 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $18.20 Median $24.55 Typical High $26.92 | Professional | RR · Rental | $18.20 | $24.55 | $26.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $138.04 Median $181.97 Typical High $199.53 | Professional | UE · Used equipment | $138.04 | $181.97 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $398.11 | Facility | None | $251.19 | $251.19 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $616.60 | Professional | None | $208.93 | $467.74 | $616.60 |
Martin's Point Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $363.08 | Professional | None | $257.04 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $741.31 | Professional | None | $190.55 | $269.15 | $741.31 |
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 $128.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $128.82 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $128.82 | $181.97 | $181.97 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $51.29 | $72.44 | $72.44 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $54.95 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $36.31 Typical High $36.31 | Professional | 56 · Pre-op care only | $25.70 | $36.31 | $36.31 |
Where Maine sits
The same service costs 3.4 times more in Montana than in New York. 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· 29th of 51
$257
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.