How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $2.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $51.29 Typical High $97.72 | Facility | None | $40.74 | $51.29 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $15.85 Median $19.95 Typical High $19.95 | Professional | None | $15.85 | $19.95 | $19.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $19.50 Median $35.48 Typical High $35.48 | Professional | None | $19.50 | $35.48 | $35.48 |
Martin's Point Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Professional | None | $23.44 | $23.44 | $23.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $11.75 Median $11.75 Typical High $11.75 | Professional | 52 · Reduced service | $11.75 | $11.75 | $11.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 53 · Discontinued | $4.68 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $2.34 |
United Setting Professional Modifier None Typical Low $15.85 Median $20.42 Typical High $20.42 | Professional | None | $15.85 | $20.42 | $20.42 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | RR · Rental | $5.50 | $5.50 | $5.50 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | UE · Used equipment | $41.69 | $41.69 | $41.69 |
Where Maine sits
The same service costs 3.2 times more in Montana than in Indiana. 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· 43rd of 51
$23.44
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.