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 $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.65 Median $0.85 Typical High $0.85 | Professional | None | $0.65 | $0.85 | $0.85 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | RR · Rental | $0.09 | $0.09 | $0.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.48 Median $0.65 Typical High $0.65 | Professional | UE · Used equipment | $0.48 | $0.65 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.91 Median $1.70 Typical High $1.70 | Professional | None | $0.91 | $1.70 | $1.70 |
Martin's Point Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
United Setting Professional Modifier None Typical Low $0.76 Median $0.95 Typical High $2.24 | Professional | None | $0.76 | $0.95 | $2.24 |
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 $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $0.56 Median $0.56 Typical High $0.56 | Professional | 52 · Reduced service | $0.56 | $0.56 | $0.56 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $0.22 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.22 | $0.22 | $0.22 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | 55 · Aftercare only | $0.17 | $0.17 | $0.17 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.11 | $0.11 | $0.11 |
Where Maine sits
The same service costs 2.6 times more in Hawaii 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· 49th of 51
$0.95
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.