How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $8.51 Median $11.22 Typical High $11.22 | Professional | None | $8.51 | $11.22 | $11.22 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | None | $9.33 | $9.33 | $10.23 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.93 Median $0.93 Typical High $1.02 | Professional | RR · Rental | $0.93 | $0.93 | $1.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.08 Median $7.08 Typical High $7.76 | Professional | UE · Used equipment | $7.08 | $7.08 | $7.76 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $12.30 Typical High $14.79 | Facility | None | $11.22 | $12.30 | $14.79 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.30 | Professional | None | $10.47 | $10.47 | $12.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.59 Median $16.98 Typical High $22.39 | Professional | None | $7.59 | $16.98 | $22.39 |
Martin's Point Setting Professional Modifier None Typical Low $8.51 Median $11.22 Typical High $11.22 | Professional | None | $8.51 | $11.22 | $11.22 |
United Setting Professional Modifier None Typical Low $7.59 Median $9.77 Typical High $26.92 | Professional | None | $7.59 | $9.77 | $26.92 |
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 $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | 55 · Aftercare only | $1.70 | $1.70 | $1.70 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.12 |
Where Maine sits
The same service costs 3.0 times more in Hawaii 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· 46th of 51
$10.23
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.