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 $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $295.12 Typical High $562.34 | Facility | None | $229.09 | $295.12 | $562.34 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Professional | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $89.13 | Professional | None | $69.18 | $89.13 | $89.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $109.65 Median $204.17 Typical High $204.17 | Professional | None | $109.65 | $204.17 | $204.17 |
Martin's Point Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 52 · Reduced service | $67.61 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 53 · Discontinued | $26.92 | $26.92 | $26.92 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | 55 · Aftercare only | $19.95 | $19.95 | $19.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $13.49 Typical High $13.49 | Professional | 56 · Pre-op care only | $13.49 | $13.49 | $13.49 |
United Setting Professional Modifier None Typical Low $109.65 Median $117.49 Typical High $117.49 | Professional | None | $109.65 | $117.49 | $117.49 |
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 $24.55 Median $24.55 Typical High $24.55 | Professional | RR · Rental | $24.55 | $24.55 | $24.55 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | UE · Used equipment | $186.21 | $186.21 | $186.21 |
Where Maine sits
The same service costs 2.6 times more in Minnesota 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· 34th of 51
$135
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.