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 $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.08 Median $7.59 Typical High $7.76 | Professional | None | $7.08 | $7.59 | $7.76 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.71 Median $0.71 Typical High $0.78 | Professional | RR · Rental | $0.71 | $0.71 | $0.78 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | UE · Used equipment | $5.37 | $5.37 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $10.00 Typical High $12.59 | Facility | None | $10.00 | $10.00 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Professional | None | $8.51 | $8.51 | $10.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.46 Median $14.45 Typical High $19.05 | Professional | None | $6.46 | $14.45 | $19.05 |
Martin's Point Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
United Setting Professional Modifier None Typical Low $6.46 Median $8.32 Typical High $22.91 | Professional | None | $6.46 | $8.32 | $22.91 |
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 $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.45 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.95 | $0.95 | $0.95 |
Where Maine sits
The same service costs 2.3 times more in Montana 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
$7.94
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.