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 $5.37 Median $7.24 Typical High $7.24 | Professional | None | $5.37 | $7.24 | $7.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.31 Median $6.76 Typical High $6.92 | Professional | None | $6.31 | $6.76 | $6.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.63 Median $0.63 Typical High $0.69 | Professional | RR · Rental | $0.63 | $0.63 | $0.69 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $4.79 Median $4.79 Typical High $5.25 | Professional | UE · Used equipment | $4.79 | $4.79 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $10.00 | Facility | None | $7.59 | $7.59 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | None | $6.46 | $6.46 | $7.59 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.90 Median $10.96 Typical High $14.45 | Professional | None | $4.90 | $10.96 | $14.45 |
Martin's Point Setting Professional Modifier None Typical Low $5.37 Median $7.24 Typical High $7.24 | Professional | None | $5.37 | $7.24 | $7.24 |
United Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $17.38 | Professional | None | $4.90 | $6.31 | $17.38 |
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 $1.10 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 55 · Aftercare only | $1.10 | $1.10 | $1.10 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.72 | $0.72 | $0.72 |
Where Maine sits
The same service costs 2.1 times more in Idaho than in New Jersey. 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· 42nd of 51
$6.76
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.