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 $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $107.15 Median $138.04 Typical High $257.04 | Facility | None | $107.15 | $138.04 | $257.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | None | $37.15 | $46.77 | $46.77 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $95.50 | Professional | None | $51.29 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $30.90 | $30.90 | $30.90 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.17 |
United Setting Professional Modifier None Typical Low $42.66 Median $53.70 Typical High $53.70 | Professional | None | $42.66 | $53.70 | $53.70 |
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 $13.18 Median $13.18 Typical High $13.18 | Professional | RR · Rental | $13.18 | $13.18 | $13.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | UE · Used equipment | $97.72 | $97.72 | $97.72 |
Where Maine sits
The same service costs 2.5 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· 38th of 51
$61.66
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.