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 $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $251.19 Median $323.59 Typical High $602.56 | Facility | None | $251.19 | $323.59 | $602.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $263.03 Typical High $288.40 | Professional | None | $199.53 | $263.03 | $288.40 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $19.95 Median $26.30 Typical High $28.84 | Professional | RR · Rental | $19.95 | $26.30 | $28.84 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $147.91 Median $199.53 Typical High $218.78 | Professional | UE · Used equipment | $147.91 | $199.53 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $354.81 | Professional | None | $109.65 | $234.42 | $354.81 |
Martin's Point Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $100.00 Median $288.40 Typical High $354.81 | Professional | None | $100.00 | $288.40 | $354.81 |
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 $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $11.48 |
Where Maine sits
The same service costs 3.3 times more in Iowa than in New York. 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· 12th of 51
$251
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.