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 Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Facility | None | $17.78 | $17.78 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $18.20 | Professional | None | $16.60 | $16.60 | $18.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.66 Median $1.66 Typical High $1.82 | Professional | RR · Rental | $1.66 | $1.66 | $1.82 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $13.80 | Professional | UE · Used equipment | $12.59 | $12.59 | $13.80 |
Cigna Setting Facility Modifier None Typical Low $5.62 Median $21.88 Typical High $23.44 | Facility | None | $5.62 | $21.88 | $23.44 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | None | $18.62 | $18.62 | $21.88 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $12.88 Median $27.54 Typical High $36.31 | Professional | None | $12.88 | $27.54 | $36.31 |
Martin's Point Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Facility | None | $17.78 | $17.78 | $21.38 |
Martin's Point Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
United Setting Professional Modifier None Typical Low $12.30 Median $15.49 Typical High $43.65 | Professional | None | $12.30 | $15.49 | $43.65 |
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 $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $1.82 |
Where Maine sits
The same service costs 2.9 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· 48th of 51
$17.78
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.