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 $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $43.65 Median $56.23 Typical High $107.15 | Facility | None | $43.65 | $56.23 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $16.60 Typical High $16.60 | Professional | None | $13.18 | $16.60 | $16.60 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $20.89 Median $38.90 Typical High $38.90 | Professional | None | $20.89 | $38.90 | $38.90 |
Martin's Point Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 52 · Reduced service | $12.59 | $12.59 | $12.59 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
United Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $21.88 | Professional | None | $20.89 | $21.88 | $21.88 |
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 $4.68 Median $4.68 Typical High $4.68 | Professional | RR · Rental | $4.68 | $4.68 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | UE · Used equipment | $34.67 | $34.67 | $34.67 |
Where Maine sits
The same service costs 5.9 times more in Hawaii 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· 30th of 51
$25.70
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.