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 $9.77 Median $12.88 Typical High $12.88 | Professional | None | $9.77 | $12.88 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | None | $10.00 | $10.00 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.00 Median $1.00 Typical High $1.12 | Professional | RR · Rental | $1.00 | $1.00 | $1.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | UE · Used equipment | $7.59 | $7.59 | $8.32 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $13.49 Typical High $16.98 | Facility | None | $10.00 | $13.49 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | None | $11.48 | $11.48 | $13.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.71 Median $18.62 Typical High $25.70 | Professional | None | $8.71 | $18.62 | $25.70 |
Martin's Point Setting Professional Modifier None Typical Low $9.55 Median $12.88 Typical High $12.88 | Professional | None | $9.55 | $12.88 | $12.88 |
United Setting Professional Modifier None Typical Low $8.71 Median $11.22 Typical High $30.90 | Professional | None | $8.71 | $11.22 | $30.90 |
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 $1.91 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $1.91 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $1.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $1.29 |
Where Maine sits
The same service costs 2.8 times more in Hawaii than in Connecticut. 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· 45th of 51
$11.22
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.