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 $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | None | $1.74 | $1.74 | $1.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.17 | $0.17 | $0.17 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.95 Median $1.29 Typical High $1.29 | Professional | UE · Used equipment | $0.95 | $1.29 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.55 Median $2.95 Typical High $3.02 | Professional | None | $1.55 | $2.95 | $3.02 |
Martin's Point Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $3.80 | Professional | None | $1.32 | $1.70 | $3.80 |
8 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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 52 · Reduced service | $1.00 | $1.00 | $1.00 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 53 · Discontinued | $0.40 | $0.40 | $0.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Where Maine sits
The same service costs 2.3 times more in Hawaii than in Kentucky. 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· 43rd of 51
$1.91
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.