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 $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $389.05 Median $501.19 Typical High $954.99 | Facility | None | $389.05 | $501.19 | $954.99 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $478.63 | Professional | None | $338.84 | $416.87 | $478.63 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $30.90 Median $41.69 Typical High $45.71 | Professional | RR · Rental | $30.90 | $41.69 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $234.42 Median $309.03 Typical High $338.84 | Professional | UE · Used equipment | $234.42 | $309.03 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Professional | None | $169.82 | $169.82 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $173.78 Median $371.54 Typical High $562.34 | Professional | None | $173.78 | $371.54 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
United Setting Professional Modifier None Typical Low $158.49 Median $446.68 Typical High $562.34 | Professional | None | $158.49 | $446.68 | $562.34 |
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 $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $27.54 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $18.20 |
Where Maine sits
The same service costs 3.2 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
$407
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.