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 $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.38 Typical High $1.45 | Professional | None | $1.29 | $1.38 | $1.45 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.14 | Professional | RR · Rental | $0.13 | $0.13 | $0.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.98 Median $0.98 Typical High $1.38 | Professional | UE · Used equipment | $0.98 | $0.98 | $1.38 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $2.04 | Facility | None | $1.55 | $1.55 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.55 | Professional | None | $1.32 | $1.32 | $1.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.00 Median $2.29 Typical High $3.02 | Professional | None | $1.00 | $2.29 | $3.02 |
Martin's Point Setting Professional Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Professional | None | $1.48 | $1.48 | $1.48 |
United Setting Professional Modifier None Typical Low $1.00 Median $1.29 Typical High $3.63 | Professional | None | $1.00 | $1.29 | $3.63 |
8 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 52 · Reduced service Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.22 | $0.22 | $0.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Maine sits
The same service costs 2.3 times more in Kansas 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
$1.38
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.