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 $0.23 Median $0.25 Typical High $0.25 | Professional | None | $0.23 | $0.25 | $0.25 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | AU · Urologic/ostomy supply | $0.15 | $0.15 | $0.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.18 Median $0.18 Typical High $0.18 | Professional | None | $0.18 | $0.18 | $0.18 |
Anthem BCBS Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.24 Median $0.28 Typical High $0.35 | Professional | AU · Urologic/ostomy supply | $0.24 | $0.28 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.13 Median $0.13 Typical High $0.17 | Professional | UE · Used equipment | $0.13 | $0.13 | $0.17 |
Cigna Setting Facility Modifier None Typical Low $0.20 Median $0.20 Typical High $0.22 | Facility | None | $0.20 | $0.20 | $0.22 |
Cigna Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.20 | Professional | None | $0.17 | $0.17 | $0.20 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.15 Median $0.33 Typical High $0.44 | Professional | None | $0.15 | $0.33 | $0.44 |
Martin's Point Setting Professional Modifier None Typical Low $0.15 Median $0.25 Typical High $0.25 | Professional | None | $0.15 | $0.25 | $0.25 |
Martin's Point Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | AU · Urologic/ostomy supply | $0.15 | $0.15 | $0.15 |
United Setting Professional Modifier None Typical Low $0.14 Median $0.19 Typical High $0.52 | Professional | None | $0.14 | $0.19 | $0.52 |
3 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 AV · With prosthetic/orthotic Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | AV · With prosthetic/orthotic | $0.17 | $0.17 | $0.17 |
Anthem BCBS Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.31 Median $0.34 Typical High $0.63 | Professional | AV · With prosthetic/orthotic | $0.31 | $0.34 | $0.63 |
Martin's Point Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | AV · With prosthetic/orthotic | $0.17 | $0.17 | $0.17 |
Where Maine sits
The same service costs 2.7 times more in Arkansas than in Utah. 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· 44th of 51
$0.18
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.