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 $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $8.71 | Professional | None | $7.94 | $8.13 | $8.71 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.79 Median $0.79 Typical High $0.85 | Professional | RR · Rental | $0.79 | $0.79 | $0.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.89 Median $5.89 Typical High $6.46 | Professional | UE · Used equipment | $5.89 | $5.89 | $6.46 |
Cigna Setting Facility Modifier None Typical Low $6.17 Median $9.55 Typical High $11.75 | Facility | None | $6.17 | $9.55 | $11.75 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.17 Median $13.80 Typical High $18.20 | Professional | None | $6.17 | $13.80 | $18.20 |
Martin's Point Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
United Setting Professional Modifier None Typical Low $6.17 Median $7.94 Typical High $21.88 | Professional | None | $6.17 | $7.94 | $21.88 |
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 $1.35 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $0.91 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.35 Typical High $1.35 | Professional | 55 · Aftercare only | $1.35 | $1.35 | $1.35 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.91 | $0.91 | $0.91 |
Where Maine sits
The same service costs 2.2 times more in Kansas 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· 42nd of 51
$8.13
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.