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 $2.95 Median $3.98 Typical High $3.98 | Professional | None | $2.95 | $3.98 | $3.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.47 Median $3.63 Typical High $3.80 | Professional | None | $3.47 | $3.63 | $3.80 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.35 Median $0.35 Typical High $0.38 | Professional | RR · Rental | $0.35 | $0.35 | $0.38 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.57 Median $2.57 Typical High $2.82 | Professional | UE · Used equipment | $2.57 | $2.57 | $2.82 |
Cigna Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $5.37 | Facility | None | $4.17 | $4.17 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $4.17 | Professional | None | $3.55 | $3.55 | $4.17 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.69 Median $6.03 Typical High $7.94 | Professional | None | $2.69 | $6.03 | $7.94 |
Martin's Point Setting Professional Modifier None Typical Low $2.95 Median $3.98 Typical High $3.98 | Professional | None | $2.95 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $2.69 Median $3.47 Typical High $9.55 | Professional | None | $2.69 | $3.47 | $9.55 |
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 $0.59 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | 55 · Aftercare only | $0.59 | $0.59 | $0.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 56 · Pre-op care only | $0.40 | $0.40 | $0.40 |
Where Maine sits
The same service costs 2.1 times more in Kansas than in Colorado. 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· 41st of 51
$3.63
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.