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 $0.98 Median $0.98 Typical High $1.15 | Professional | None | $0.98 | $0.98 | $1.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.07 Median $1.41 Typical High $1.41 | Professional | None | $1.07 | $1.41 | $1.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.79 Median $1.07 Typical High $1.07 | Professional | UE · Used equipment | $0.79 | $1.07 | $1.07 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.02 | Professional | None | $1.02 | $1.02 | $1.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.85 Median $1.23 Typical High $11.48 | Professional | None | $0.85 | $1.23 | $11.48 |
Martin's Point Setting Professional Modifier None Typical Low $0.98 Median $0.98 Typical High $1.41 | Professional | None | $0.98 | $0.98 | $1.41 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.10 |
United Setting Professional Modifier None Typical Low $0.56 Median $6.17 Typical High $14.79 | Professional | None | $0.56 | $6.17 | $14.79 |
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 |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier KL · Delivered by mail Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | KL · Delivered by mail | $5.75 | $5.75 | $5.75 |
Martin's Point Setting Professional Modifier KL · Delivered by mail Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | KL · Delivered by mail | $5.75 | $5.75 | $5.75 |
Where Maine sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 34th of 51
$1.23
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.