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 $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $109.65 Typical High $208.93 | Facility | None | $85.11 | $109.65 | $208.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $33.11 Median $41.69 Typical High $41.69 | Professional | None | $33.11 | $41.69 | $41.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $40.74 Median $75.86 Typical High $75.86 | Professional | None | $40.74 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $24.55 | $24.55 | $24.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.00 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.41 | $7.41 | $7.41 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $33.88 Median $42.66 Typical High $42.66 | Professional | None | $33.88 | $42.66 | $42.66 |
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 $11.75 Median $11.75 Typical High $11.75 | Professional | RR · Rental | $11.75 | $11.75 | $11.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | UE · Used equipment | $87.10 | $87.10 | $87.10 |
Where Maine sits
The same service costs 2.4 times more in Hawaii than in Ohio. 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· 40th of 51
$50.12
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.