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 $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.05 Median $24.55 Typical High $46.77 | Facility | None | $19.05 | $24.55 | $46.77 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $15.49 | Professional | None | $14.79 | $14.79 | $15.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.48 Median $1.48 Typical High $1.51 | Professional | RR · Rental | $1.48 | $1.48 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $11.22 Median $11.22 Typical High $11.48 | Professional | UE · Used equipment | $11.22 | $11.22 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $9.12 Median $21.38 Typical High $33.88 | Professional | None | $9.12 | $21.38 | $33.88 |
Martin's Point Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $7.59 Median $27.54 Typical High $33.88 | Professional | None | $7.59 | $27.54 | $33.88 |
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 $1.62 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $1.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.10 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.10 |
Where Maine sits
The same service costs 3.5 times more in Florida than in Alabama. 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· 44th of 51
$15.49
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.