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 $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | None | $17.38 | $17.38 | $19.05 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.74 Median $1.74 Typical High $1.91 | Professional | RR · Rental | $1.74 | $1.74 | $1.91 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.88 Median $12.88 Typical High $14.13 | Professional | UE · Used equipment | $12.88 | $12.88 | $14.13 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $26.92 Typical High $33.11 | Facility | None | $22.91 | $26.92 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | None | $22.91 | $22.91 | $26.92 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $17.38 Median $38.90 Typical High $51.29 | Professional | None | $17.38 | $38.90 | $51.29 |
Martin's Point Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
United Setting Professional Modifier None Typical Low $17.38 Median $21.88 Typical High $61.66 | Professional | None | $17.38 | $21.88 | $61.66 |
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 $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $3.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $2.51 |
Where Maine sits
The same service costs 2.5 times more in Idaho than in Kentucky. 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
$21.88
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.