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 $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.78 Median $1.00 Typical High $1.86 | Facility | None | $0.78 | $1.00 | $1.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.72 | Professional | None | $0.71 | $0.71 | $0.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | RR · Rental | $0.07 | $0.07 | $0.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | UE · Used equipment | $0.52 | $0.52 | $0.52 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $1.82 | Professional | None | $1.82 | $1.82 | $1.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.31 Median $1.38 Typical High $1.74 | Professional | None | $0.31 | $1.38 | $1.74 |
Martin's Point Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $0.55 | Professional | None | $0.55 | $0.55 | $0.55 |
United Setting Professional Modifier None Typical Low $0.31 Median $1.38 Typical High $1.74 | Professional | None | $0.31 | $1.38 | $1.74 |
3 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 $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.08 | $0.08 | $0.08 |
Where Maine sits
The same service costs 3.2 times more in Texas 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
$0.72
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.