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 $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
Anthem BCBS Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $21.88 | Professional | None | $19.95 | $19.95 | $21.88 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | RR · Rental | $1.95 | $1.95 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $16.22 | Professional | UE · Used equipment | $14.79 | $14.79 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $26.30 Median $26.30 Typical High $29.51 | Facility | None | $26.30 | $26.30 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $22.39 Typical High $22.39 | Professional | None | $16.22 | $22.39 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.49 Median $34.67 Typical High $44.67 | Professional | None | $15.49 | $34.67 | $44.67 |
Martin's Point Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | None | $22.39 | $22.39 | $22.39 |
United Setting Professional Modifier None Typical Low $15.49 Median $19.50 Typical High $54.95 | Professional | None | $15.49 | $19.50 | $54.95 |
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 $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.24 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.39 | $3.39 | $3.39 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | 56 · Pre-op care only | $2.24 | $2.24 | $2.24 |
Where Maine sits
The same service costs 3.0 times more in Hawaii than in Kansas. 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
$19.95
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.