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 $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $57.54 Typical High $109.65 | Facility | None | $44.67 | $57.54 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | None | $17.38 | $22.39 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $21.38 Median $39.81 Typical High $39.81 | Professional | None | $21.38 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 52 · Reduced service | $12.88 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
United Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $22.39 | Professional | None | $17.78 | $22.39 | $22.39 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | RR · Rental | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | UE · Used equipment | $45.71 | $45.71 | $45.71 |
Where Maine sits
The same service costs 3.3 times more in Montana than in Missouri. 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
$25.70
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.