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 $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $81.28 Median $104.71 Typical High $194.98 | Facility | None | $81.28 | $104.71 | $194.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $85.11 Typical High $97.72 | Professional | None | $69.18 | $85.11 | $97.72 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $6.46 Median $8.51 Typical High $9.33 | Professional | RR · Rental | $6.46 | $8.51 | $9.33 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $47.86 Median $64.57 Typical High $70.79 | Professional | UE · Used equipment | $47.86 | $64.57 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | None | $0.09 | $0.09 | $0.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $35.48 Median $75.86 Typical High $114.82 | Professional | None | $35.48 | $75.86 | $114.82 |
Martin's Point Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
United Setting Professional Modifier None Typical Low $32.36 Median $93.33 Typical High $114.82 | Professional | None | $32.36 | $93.33 | $114.82 |
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 $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $3.72 |
Where Maine sits
The same service costs 5.5 times more in Iowa than in Kansas. 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· 11th of 51
$83.18
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.