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 $3.72 Median $5.13 Typical High $5.13 | Professional | None | $3.72 | $5.13 | $5.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.80 | Professional | None | $3.47 | $3.47 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.34 Median $0.34 Typical High $0.37 | Professional | RR · Rental | $0.34 | $0.34 | $0.37 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $2.95 Median $5.37 Typical High $6.76 | Facility | None | $2.95 | $5.37 | $6.76 |
Cigna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | None | $4.57 | $4.57 | $5.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.47 Median $7.76 Typical High $10.23 | Professional | None | $3.47 | $7.76 | $10.23 |
Martin's Point Setting Professional Modifier None Typical Low $3.72 Median $5.13 Typical High $5.13 | Professional | None | $3.72 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.47 Typical High $12.30 | Professional | None | $3.47 | $4.47 | $12.30 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where Maine sits
The same service costs 4.2 times more in Hawaii 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
$4.47
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.