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 $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $2,691.53 | Professional | None | $1,412.54 | $1,412.54 | $2,691.53 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $107.15 Median $141.25 Typical High $158.49 | Professional | RR · Rental | $107.15 | $141.25 | $158.49 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $794.33 Median $1,071.52 Typical High $1,174.90 | Professional | UE · Used equipment | $794.33 | $1,071.52 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,949.84 | Facility | None | $1,479.11 | $1,479.11 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,023.29 Median $2,290.87 Typical High $3,019.95 | Professional | None | $1,023.29 | $2,290.87 | $3,019.95 |
Martin's Point Setting Professional Modifier None Typical Low $1,412.54 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,778.28 | $1,778.28 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $3,630.78 | Professional | None | $1,023.29 | $1,318.26 | $3,630.78 |
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 $707.95 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $177.83 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $707.95 Median $891.25 Typical High $891.25 | Professional | 52 · Reduced service | $707.95 | $891.25 | $891.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $354.81 Typical High $354.81 | Professional | 53 · Discontinued | $281.84 | $354.81 | $354.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $263.03 | $263.03 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $177.83 Typical High $177.83 | Professional | 56 · Pre-op care only | $141.25 | $177.83 | $177.83 |
Where Maine sits
The same service costs 2.6 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· 37th of 51
$1,413
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.