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 $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $97.72 Typical High $186.21 | Facility | None | $75.86 | $97.72 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $37.15 | Professional | None | $28.84 | $37.15 | $37.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $36.31 Median $67.61 Typical High $67.61 | Professional | None | $36.31 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.61 | $6.61 | $6.61 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
United Setting Professional Modifier None Typical Low $30.20 Median $38.90 Typical High $38.90 | Professional | None | $30.20 | $38.90 | $38.90 |
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 $10.23 Median $10.23 Typical High $10.23 | Professional | RR · Rental | $10.23 | $10.23 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | UE · Used equipment | $77.62 | $77.62 | $77.62 |
Where Maine sits
The same service costs 2.6 times more in Montana than in Nebraska. 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· 39th of 51
$44.67
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.