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 $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.51 Median $2.95 Typical High $3.16 | Professional | None | $2.51 | $2.95 | $3.16 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.31 | Professional | RR · Rental | $0.28 | $0.28 | $0.31 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.19 Median $2.19 Typical High $2.40 | Professional | UE · Used equipment | $2.19 | $2.19 | $2.40 |
Cigna Setting Facility Modifier None Typical Low $3.80 Median $3.80 Typical High $4.37 | Facility | None | $3.80 | $3.80 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $3.24 Typical High $3.24 | Professional | None | $2.45 | $3.24 | $3.24 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.29 Median $5.13 Typical High $6.76 | Professional | None | $2.29 | $5.13 | $6.76 |
Martin's Point Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | None | $3.39 | $3.39 | $3.39 |
United Setting Professional Modifier None Typical Low $2.29 Median $2.95 Typical High $8.13 | Professional | None | $2.29 | $2.95 | $8.13 |
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 $0.50 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 55 · Aftercare only | $0.50 | $0.50 | $0.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $0.34 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.34 | $0.34 | $0.34 |
Where Maine sits
The same service costs 3.2 times more in Kansas 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· 46th of 51
$3.09
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.