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 $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.13 Median $6.46 Typical High $12.30 | Facility | None | $5.13 | $6.46 | $12.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.37 Typical High $4.57 | Professional | None | $4.27 | $4.37 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.44 Median $0.44 Typical High $0.45 | Professional | RR · Rental | $0.44 | $0.44 | $0.45 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.31 Median $3.31 Typical High $3.39 | Professional | UE · Used equipment | $3.31 | $3.31 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | None | $2.57 | $2.57 | $2.57 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.75 Median $7.59 Typical High $11.22 | Professional | None | $2.75 | $7.59 | $11.22 |
Martin's Point Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
United Setting Professional Modifier None Typical Low $2.04 Median $8.91 Typical High $11.22 | Professional | None | $2.04 | $8.91 | $11.22 |
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 $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.54 Median $0.54 Typical High $0.54 | Professional | 55 · Aftercare only | $0.54 | $0.54 | $0.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | 56 · Pre-op care only | $0.36 | $0.36 | $0.36 |
Where Maine sits
The same service costs 4.2 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
$4.37
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.