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 $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $269.15 | Facility | None | $109.65 | $141.25 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $45.71 | Professional | None | $36.31 | $45.71 | $45.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $53.70 Median $97.72 Typical High $97.72 | Professional | None | $53.70 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | None | $64.57 | $64.57 | $64.57 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | 52 · Reduced service | $32.36 | $32.36 | $32.36 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $12.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $12.88 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $9.55 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $43.65 Median $56.23 Typical High $56.23 | Professional | None | $43.65 | $56.23 | $56.23 |
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 $12.59 Median $12.59 Typical High $12.59 | Professional | RR · Rental | $12.59 | $12.59 | $12.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | UE · Used equipment | $95.50 | $95.50 | $95.50 |
Where Maine sits
The same service costs 2.3 times more in Hawaii than in Utah. 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· 35th of 51
$64.57
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.