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 $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $446.68 | Professional | None | $58.88 | $58.88 | $446.68 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $67.61 Median $125.89 Typical High $125.89 | Professional | None | $67.61 | $125.89 | $125.89 |
Martin's Point Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $40.74 | $40.74 | $40.74 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $16.22 | $16.22 | $16.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $67.61 Median $70.79 Typical High $70.79 | Professional | None | $67.61 | $70.79 | $70.79 |
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 $14.45 Median $14.45 Typical High $14.45 | Professional | RR · Rental | $14.45 | $14.45 | $14.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | UE · Used equipment | $109.65 | $109.65 | $109.65 |
Where Maine sits
The same service costs 3.0 times more in California than in New York. 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· 42nd of 51
$81.28
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.