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 $363.08 Median $446.68 Typical High $446.68 | Professional | None | $363.08 | $446.68 | $446.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $363.08 Typical High $676.08 | Professional | None | $269.15 | $363.08 | $676.08 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $26.92 Median $36.31 Typical High $39.81 | Professional | RR · Rental | $26.92 | $36.31 | $39.81 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $204.17 Median $269.15 Typical High $295.12 | Professional | UE · Used equipment | $204.17 | $269.15 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $371.54 Typical High $489.78 | Facility | None | $371.54 | $371.54 | $489.78 |
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 $263.03 Median $588.84 Typical High $758.58 | Professional | None | $263.03 | $588.84 | $758.58 |
Martin's Point Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $446.68 | Professional | None | $363.08 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $263.03 Median $331.13 Typical High $933.25 | Professional | None | $263.03 | $331.13 | $933.25 |
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 $181.97 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $181.97 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $72.44 | $89.13 | $89.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $53.70 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $36.31 | $44.67 | $44.67 |
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· 32nd of 51
$363
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.