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 $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $17.38 | Professional | None | $15.85 | $15.85 | $17.38 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.58 Median $1.58 Typical High $1.74 | Professional | RR · Rental | $1.58 | $1.58 | $1.74 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | UE · Used equipment | $12.02 | $12.02 | $13.18 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $21.38 Typical High $22.91 | Facility | None | $17.78 | $21.38 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.59 Median $26.30 Typical High $34.67 | Professional | None | $12.59 | $26.30 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $11.75 Median $15.14 Typical High $41.69 | Professional | None | $11.75 | $15.14 | $41.69 |
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 $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.57 | $2.57 | $2.57 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.74 | $1.74 | $1.74 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in New Hampshire. 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· 48th of 51
$17.38
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.