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 $4.27 Median $5.62 Typical High $5.62 | Professional | None | $4.27 | $5.62 | $5.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $4.17 | Professional | None | $3.80 | $3.80 | $4.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.38 Median $0.38 Typical High $0.41 | Professional | RR · Rental | $0.38 | $0.38 | $0.41 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.69 Median $2.69 Typical High $2.95 | Professional | UE · Used equipment | $2.69 | $2.69 | $2.95 |
Cigna Setting Facility Modifier None Typical Low $4.57 Median $5.89 Typical High $7.41 | Facility | None | $4.57 | $5.89 | $7.41 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.89 | Professional | None | $5.01 | $5.01 | $5.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.80 Median $8.51 Typical High $11.22 | Professional | None | $3.80 | $8.51 | $11.22 |
Martin's Point Setting Professional Modifier None Typical Low $4.27 Median $5.62 Typical High $5.62 | Professional | None | $4.27 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $3.80 Median $4.90 Typical High $13.49 | Professional | None | $3.80 | $4.90 | $13.49 |
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 $0.83 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.83 | $0.83 | $0.83 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.56 |
Where Maine sits
The same service costs 2.4 times more in Kansas 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· 50th of 51
$4.90
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.