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 $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $30.20 | Professional | None | $26.92 | $26.92 | $30.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.69 Median $2.69 Typical High $3.02 | Professional | RR · Rental | $2.69 | $2.69 | $3.02 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.42 Median $20.42 Typical High $22.39 | Professional | UE · Used equipment | $20.42 | $20.42 | $22.39 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $40.74 | Facility | None | $38.02 | $38.02 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $22.39 Median $47.86 Typical High $61.66 | Professional | None | $22.39 | $47.86 | $61.66 |
Martin's Point Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $21.38 Median $26.92 Typical High $75.86 | Professional | None | $21.38 | $26.92 | $75.86 |
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 $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 55 · Aftercare only | $4.68 | $4.68 | $4.68 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.09 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in New Hampshire. 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· 47th of 51
$30.90
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.