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 $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $1.95 Median $2.45 Typical High $4.68 | Facility | None | $1.95 | $2.45 | $4.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $1.58 Median $1.58 Typical High $1.78 | Professional | None | $1.58 | $1.58 | $1.78 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | RR · Rental | $0.16 | $0.16 | $0.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | UE · Used equipment | $1.20 | $1.20 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $1.17 Median $1.17 Typical High $1.70 | Professional | None | $1.17 | $1.17 | $1.70 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.95 Median $2.40 Typical High $3.80 | Professional | None | $0.95 | $2.40 | $3.80 |
Martin's Point Setting Professional Modifier None Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | None | $1.20 | $1.20 | $1.20 |
United Setting Professional Modifier None Typical Low $0.78 Median $3.02 Typical High $3.80 | Professional | None | $0.78 | $3.02 | $3.80 |
2 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 $0.18 Median $0.18 Typical High $0.18 | Professional | 55 · Aftercare only | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.12 | $0.12 | $0.12 |
Where Maine sits
The same service costs 33.1 times more in Kansas 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· 48th of 51
$1.58
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.