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 $2.14 Median $2.82 Typical High $2.82 | Professional | None | $2.14 | $2.82 | $2.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.40 Median $2.51 Typical High $2.63 | Professional | None | $2.40 | $2.51 | $2.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | RR · Rental | $0.24 | $0.24 | $0.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.78 Median $1.78 Typical High $1.95 | Professional | UE · Used equipment | $1.78 | $1.78 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $2.82 Median $2.95 Typical High $3.16 | Facility | None | $2.82 | $2.95 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.95 | Professional | None | $2.51 | $2.51 | $2.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.95 Median $4.37 Typical High $5.62 | Professional | None | $1.95 | $4.37 | $5.62 |
Martin's Point Setting Professional Modifier None Typical Low $2.14 Median $2.82 Typical High $2.82 | Professional | None | $2.14 | $2.82 | $2.82 |
United Setting Professional Modifier None Typical Low $1.95 Median $2.45 Typical High $6.76 | Professional | None | $1.95 | $2.45 | $6.76 |
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 $0.42 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.42 Typical High $0.42 | Professional | 55 · Aftercare only | $0.42 | $0.42 | $0.42 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.28 |
Where Maine sits
The same service costs 2.1 times more in Montana 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· 47th of 51
$2.51
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.