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 $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.14 Median $2.24 Typical High $2.34 | Professional | None | $2.14 | $2.24 | $2.34 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.21 Median $0.21 Typical High $0.23 | Professional | RR · Rental | $0.21 | $0.21 | $0.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.58 Median $1.58 Typical High $1.78 | Professional | UE · Used equipment | $1.58 | $1.58 | $1.78 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $2.69 Typical High $3.31 | Facility | None | $2.69 | $2.69 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.29 Median $2.29 Typical High $2.69 | Professional | None | $2.29 | $2.29 | $2.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.74 Median $3.89 Typical High $5.13 | Professional | None | $1.74 | $3.89 | $5.13 |
Martin's Point Setting Professional Modifier None Typical Low $2.51 Median $2.51 Typical High $2.51 | Professional | None | $2.51 | $2.51 | $2.51 |
United Setting Professional Modifier None Typical Low $1.74 Median $2.19 Typical High $6.17 | Professional | None | $1.74 | $2.19 | $6.17 |
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 $0.38 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.26 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.38 Typical High $0.38 | Professional | 55 · Aftercare only | $0.38 | $0.38 | $0.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.26 |
Where Maine sits
The same service costs 2.3 times more in Hawaii than in Connecticut. 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· 48th of 51
$2.24
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.