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 $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $11.22 | Professional | None | $10.47 | $10.47 | $11.22 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.05 Median $1.05 Typical High $1.15 | Professional | RR · Rental | $1.05 | $1.05 | $1.15 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $8.71 | Professional | UE · Used equipment | $7.94 | $7.94 | $8.71 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $15.85 | Facility | None | $13.80 | $13.80 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $11.75 Typical High $11.75 | Professional | None | $8.71 | $11.75 | $11.75 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.13 Median $18.20 Typical High $23.99 | Professional | None | $8.13 | $18.20 | $23.99 |
Martin's Point Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
United Setting Professional Modifier None Typical Low $8.13 Median $10.47 Typical High $28.84 | Professional | None | $8.13 | $10.47 | $28.84 |
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 $1.82 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Where Maine sits
The same service costs 2.3 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
$11.22
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.