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 $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.72 Median $4.79 Typical High $8.91 | Facility | None | $3.72 | $4.79 | $8.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $3.09 Median $3.24 Typical High $3.39 | Professional | None | $3.09 | $3.24 | $3.39 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.32 Median $0.32 Typical High $0.35 | Professional | RR · Rental | $0.32 | $0.32 | $0.35 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $2.40 Median $2.40 Typical High $2.51 | Professional | UE · Used equipment | $2.40 | $2.40 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.04 Median $5.75 Typical High $8.32 | Professional | None | $2.04 | $5.75 | $8.32 |
Martin's Point Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
United Setting Professional Modifier None Typical Low $1.48 Median $6.76 Typical High $8.32 | Professional | None | $1.48 | $6.76 | $8.32 |
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 $0.40 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | 55 · Aftercare only | $0.40 | $0.40 | $0.40 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.27 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.27 | $0.27 | $0.27 |
Where Maine sits
The same service costs 5.2 times more in Kansas than in Delaware. 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
$3.24
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.