How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.87 Median $1.17 Typical High $1.17 | Professional | None | $0.87 | $1.17 | $1.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | RR · Rental | $0.12 | $0.12 | $0.12 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.66 Median $0.87 Typical High $0.87 | Professional | UE · Used equipment | $0.66 | $0.87 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Professional | None | $1.32 | $1.32 | $1.32 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.26 Median $2.29 Typical High $2.29 | Professional | None | $1.26 | $2.29 | $2.29 |
Martin's Point Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | None | $1.51 | $1.51 | $1.51 |
United Setting Professional Modifier None Typical Low $1.02 Median $1.32 Typical High $3.02 | Professional | None | $1.02 | $1.32 | $3.02 |
8 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 52 · Reduced service Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.76 | $0.76 | $0.76 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.30 | $0.30 | $0.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Maine sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 43rd of 51
$1.32
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.