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 $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Anthem BCBS Setting Facility Modifier None Typical Low $13.18 Median $16.98 Typical High $32.36 | Facility | None | $13.18 | $16.98 | $32.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | None | $10.47 | $10.47 | $10.96 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.07 Median $1.07 Typical High $1.10 | Professional | RR · Rental | $1.07 | $1.07 | $1.10 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $7.94 Median $7.94 Typical High $8.13 | Professional | UE · Used equipment | $7.94 | $7.94 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.46 Median $15.14 Typical High $25.12 | Professional | None | $6.46 | $15.14 | $25.12 |
Martin's Point Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $5.37 Median $19.95 Typical High $25.12 | Professional | None | $5.37 | $19.95 | $25.12 |
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 $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
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· 46th of 51
$10.96
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.