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 $1.48 Median $1.95 Typical High $1.95 | Professional | None | $1.48 | $1.95 | $1.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.74 Median $1.82 Typical High $1.91 | Professional | None | $1.74 | $1.82 | $1.91 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | RR · Rental | $0.17 | $0.17 | $0.18 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.29 Median $1.29 Typical High $1.41 | Professional | UE · Used equipment | $1.29 | $1.29 | $1.41 |
Cigna Setting Facility Modifier None Typical Low $1.91 Median $2.04 Typical High $2.51 | Facility | None | $1.91 | $2.04 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.32 Median $2.95 Typical High $3.89 | Professional | None | $1.32 | $2.95 | $3.89 |
Martin's Point Setting Professional Modifier None Typical Low $1.48 Median $1.95 Typical High $1.95 | Professional | None | $1.48 | $1.95 | $1.95 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $4.68 | Professional | None | $1.32 | $1.70 | $4.68 |
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 $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.28 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.20 |
Where Maine sits
The same service costs 3.8 times more in Kansas than in Alabama. 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· 37th of 51
$1.82
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.