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 $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $194.98 Median $251.19 Typical High $478.63 | Facility | None | $194.98 | $251.19 | $478.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $72.44 | Professional | None | $57.54 | $72.44 | $72.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $173.78 Typical High $173.78 | Professional | None | $93.33 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $22.91 | $22.91 | $22.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $16.98 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
United Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $97.72 | Professional | None | $93.33 | $97.72 | $97.72 |
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 $20.42 Median $20.42 Typical High $20.42 | Professional | RR · Rental | $20.42 | $20.42 | $20.42 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | UE · Used equipment | $151.36 | $151.36 | $151.36 |
Where Maine sits
The same service costs 2.6 times more in Montana 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· 29th of 51
$115
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.