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 $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.95 Median $25.70 Typical High $48.98 | Facility | None | $19.95 | $25.70 | $48.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | None | $26.30 | $26.30 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $9.33 Typical High $9.33 | Professional | None | $7.41 | $9.33 | $9.33 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $9.55 Median $17.78 Typical High $17.78 | Professional | None | $9.55 | $17.78 | $17.78 |
Martin's Point Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | None | $11.48 | $11.48 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.75 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.74 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.15 |
United Setting Professional Modifier None Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | None | $9.55 | $10.00 | $10.00 |
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 $2.63 Median $2.63 Typical High $2.63 | Professional | RR · Rental | $2.63 | $2.63 | $2.63 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | UE · Used equipment | $19.50 | $19.50 | $19.50 |
Where Maine sits
The same service costs 4.2 times more in Hawaii 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
$11.48
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.