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 $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $11.48 Typical High $12.02 | Professional | None | $10.96 | $11.48 | $12.02 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.10 Median $1.10 Typical High $1.20 | Professional | RR · Rental | $1.10 | $1.10 | $1.20 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | UE · Used equipment | $8.13 | $8.13 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $15.49 Median $15.49 Typical High $18.62 | Facility | None | $15.49 | $15.49 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | None | $13.18 | $13.18 | $15.49 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $9.77 Median $21.88 Typical High $28.84 | Professional | None | $9.77 | $21.88 | $28.84 |
Martin's Point Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | None | $14.13 | $14.13 | $14.13 |
United Setting Professional Modifier None Typical Low $9.77 Median $12.30 Typical High $34.67 | Professional | None | $9.77 | $12.30 | $34.67 |
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 $2.14 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | 55 · Aftercare only | $2.14 | $2.14 | $2.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $1.45 |
Where Maine sits
The same service costs 3.5 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· 48th of 51
$12.02
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.