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 $263.03 Median $380.19 Typical High $380.19 | Professional | None | $263.03 | $380.19 | $380.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $575.44 | Professional | None | $251.19 | $251.19 | $575.44 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.05 Median $25.12 Typical High $27.54 | Professional | RR · Rental | $19.05 | $25.12 | $27.54 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $141.25 Median $190.55 Typical High $208.93 | Professional | UE · Used equipment | $141.25 | $190.55 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $407.38 | Facility | None | $371.54 | $371.54 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $371.54 | Professional | None | $316.23 | $316.23 | $371.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $218.78 Median $489.78 Typical High $645.65 | Professional | None | $218.78 | $489.78 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $380.19 Typical High $380.19 | Professional | None | $263.03 | $380.19 | $380.19 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
United Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $776.25 | Professional | None | $194.98 | $281.84 | $776.25 |
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 $131.83 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $131.83 | $190.55 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $52.48 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $39.81 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $131.83 Median $190.55 Typical High $190.55 | Professional | 52 · Reduced service | $131.83 | $190.55 | $190.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $75.86 Typical High $75.86 | Professional | 53 · Discontinued | $52.48 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $56.23 Typical High $56.23 | Professional | 55 · Aftercare only | $39.81 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $38.02 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $38.02 |
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· 23rd of 51
$316
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.