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 $1.41 Median $1.41 Typical High $2.14 | Professional | None | $1.41 | $1.41 | $2.14 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | None | $1.29 | $1.29 | $1.29 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | RR · Rental | $0.13 | $0.13 | $0.13 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.72 Median $0.95 Typical High $0.95 | Professional | UE · Used equipment | $0.72 | $0.95 | $0.95 |
Cigna Setting Professional Modifier None Typical Low $1.02 Median $1.02 Typical High $1.12 | Professional | None | $1.02 | $1.02 | $1.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1.15 Median $2.14 Typical High $2.14 | Professional | None | $1.15 | $2.14 | $2.14 |
Martin's Point Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.82 | Professional | None | $1.41 | $1.41 | $1.82 |
United Setting Professional Modifier None Typical Low $0.95 Median $1.23 Typical High $2.82 | Professional | None | $0.95 | $1.23 | $2.82 |
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 $0.71 Median $0.71 Typical High $0.71 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 52 · Reduced service | $0.71 | $0.71 | $0.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.28 | $0.28 | $0.28 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.21 Median $0.21 Typical High $0.21 | Professional | 55 · Aftercare only | $0.21 | $0.21 | $0.21 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.14 | $0.14 | $0.14 |
Where Maine sits
The same service costs 4.6 times more in Rhode Island 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· 37th of 51
$1.29
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.