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 $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.17 Median $4.47 Typical High $4.57 | Professional | None | $4.17 | $4.47 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.42 Median $0.42 Typical High $0.46 | Professional | RR · Rental | $0.42 | $0.42 | $0.46 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | UE · Used equipment | $3.16 | $3.16 | $3.47 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $5.01 Typical High $6.61 | Facility | None | $4.68 | $5.01 | $6.61 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.01 | Professional | None | $4.27 | $4.27 | $5.01 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $3.24 Median $7.41 Typical High $9.55 | Professional | None | $3.24 | $7.41 | $9.55 |
Martin's Point Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Professional | None | $4.79 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $11.48 | Professional | None | $3.24 | $4.17 | $11.48 |
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 $0.72 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | 55 · Aftercare only | $0.72 | $0.72 | $0.72 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | 56 · Pre-op care only | $0.48 | $0.48 | $0.48 |
Where Maine sits
The same service costs 2.1 times more in Hawaii than in Delaware. 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· 43rd of 51
$4.47
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.