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 $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.09 Median $2.69 Typical High $2.82 | Professional | None | $2.09 | $2.69 | $2.82 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.20 Median $0.27 Typical High $0.27 | Professional | RR · Rental | $0.20 | $0.27 | $0.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.51 Median $2.04 Typical High $2.04 | Professional | UE · Used equipment | $1.51 | $2.04 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $3.98 | Professional | None | $3.98 | $3.98 | $3.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.17 Median $2.88 Typical High $4.37 | Professional | None | $1.17 | $2.88 | $4.37 |
Martin's Point Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.29 Typical High $2.88 | Professional | None | $0.87 | $1.29 | $2.88 |
4 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 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Maine sits
The same service costs 6.0 times more in Minnesota than in Rhode Island. 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· 11th of 51
$2.69
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.