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 $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $346.74 | Professional | None | $204.17 | $204.17 | $346.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $15.49 Median $20.42 Typical High $22.39 | Professional | RR · Rental | $15.49 | $20.42 | $22.39 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $114.82 Median $154.88 Typical High $169.82 | Professional | UE · Used equipment | $114.82 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $302.00 Typical High $302.00 | Facility | None | $239.88 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $302.00 | Professional | None | $257.04 | $257.04 | $302.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $389.05 | Professional | None | $141.25 | $295.12 | $389.05 |
Martin's Point Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $229.09 | Professional | None | $204.17 | $229.09 | $229.09 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $131.83 Median $169.82 Typical High $467.74 | Professional | None | $131.83 | $169.82 | $467.74 |
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 $102.33 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $45.71 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $114.82 Typical High $114.82 | Professional | 52 · Reduced service | $102.33 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $45.71 | Professional | 53 · Discontinued | $40.74 | $45.71 | $45.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $34.67 Typical High $34.67 | Professional | 55 · Aftercare only | $30.90 | $34.67 | $34.67 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $22.91 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $22.91 |
Where Maine sits
The same service costs 3.0 times more in Iowa 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· 42nd of 51
$229
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.