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 $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $151.36 | Facility | None | $61.66 | $79.43 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $30.90 Typical High $30.90 | Professional | None | $23.99 | $30.90 | $30.90 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $29.51 Median $54.95 Typical High $54.95 | Professional | None | $29.51 | $54.95 | $54.95 |
Martin's Point Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $5.37 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
United Setting Professional Modifier None Typical Low $24.55 Median $31.62 Typical High $31.62 | Professional | None | $24.55 | $31.62 | $31.62 |
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 $8.51 Median $8.51 Typical High $8.51 | Professional | RR · Rental | $8.51 | $8.51 | $8.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $64.57 Median $64.57 Typical High $64.57 | Professional | UE · Used equipment | $64.57 | $64.57 | $64.57 |
Where Maine sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 44th of 51
$36.31
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.