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 $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.09 | Professional | None | $2.82 | $2.82 | $3.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | RR · Rental | $0.28 | $0.28 | $0.30 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.09 Median $2.09 Typical High $2.29 | Professional | UE · Used equipment | $2.09 | $2.09 | $2.29 |
Cigna Setting Facility Modifier None Typical Low $3.89 Median $3.98 Typical High $4.68 | Facility | None | $3.89 | $3.98 | $4.68 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.98 | Professional | None | $3.39 | $3.39 | $3.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.45 Median $5.50 Typical High $7.08 | Professional | None | $2.45 | $5.50 | $7.08 |
Martin's Point Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $2.45 Median $3.09 Typical High $8.71 | Professional | None | $2.45 | $3.09 | $8.71 |
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 $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Maine sits
The same service costs 2.2 times more in Minnesota 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
$3.09
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.