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 $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | RR · Rental | $0.32 | $0.32 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $2.63 | Professional | UE · Used equipment | $2.40 | $2.40 | $2.63 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $4.79 | Facility | None | $3.89 | $3.89 | $4.79 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.31 Typical High $3.89 | Professional | None | $3.31 | $3.31 | $3.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.51 Median $5.62 Typical High $7.41 | Professional | None | $2.51 | $5.62 | $7.41 |
Martin's Point Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | None | $3.72 | $3.72 | $3.72 |
United Setting Professional Modifier None Typical Low $2.51 Median $3.24 Typical High $8.91 | Professional | None | $2.51 | $3.24 | $8.91 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.37 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.56 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.37 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.37 |
Where Maine sits
The same service costs 2.6 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· 47th of 51
$3.31
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.