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 $5.37 Median $6.03 Typical High $6.03 | Professional | None | $5.37 | $6.03 | $6.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | None | $5.37 | $5.37 | $5.89 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.54 Median $0.54 Typical High $0.59 | Professional | RR · Rental | $0.54 | $0.54 | $0.59 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.98 Median $3.98 Typical High $4.37 | Professional | UE · Used equipment | $3.98 | $3.98 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $5.89 Median $5.89 Typical High $7.94 | Facility | None | $5.89 | $5.89 | $7.94 |
Cigna Setting Professional Modifier None Typical Low $5.01 Median $5.13 Typical High $5.13 | Professional | None | $5.01 | $5.13 | $5.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.37 Median $9.33 Typical High $12.02 | Professional | None | $4.37 | $9.33 | $12.02 |
Martin's Point Setting Professional Modifier None Typical Low $5.37 Median $6.03 Typical High $6.03 | Professional | None | $5.37 | $6.03 | $6.03 |
United Setting Professional Modifier None Typical Low $4.17 Median $5.25 Typical High $14.79 | Professional | None | $4.17 | $5.25 | $14.79 |
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 $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $0.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $0.62 |
Where Maine sits
The same service costs 2.7 times more in Hawaii than in Vermont. 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
$5.37
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.