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 $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.96 Median $13.80 Typical High $26.30 | Facility | None | $10.96 | $13.80 | $26.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $12.59 | Professional | None | $8.51 | $11.48 | $12.59 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.85 Median $1.12 Typical High $1.26 | Professional | RR · Rental | $0.85 | $1.12 | $1.26 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.46 Median $8.51 Typical High $9.33 | Professional | UE · Used equipment | $6.46 | $8.51 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.79 Median $10.23 Typical High $15.49 | Professional | None | $4.79 | $10.23 | $15.49 |
Martin's Point Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $4.37 Median $12.30 Typical High $15.49 | Professional | None | $4.37 | $12.30 | $15.49 |
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 $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $0.50 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | 55 · Aftercare only | $0.76 | $0.76 | $0.76 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | 56 · Pre-op care only | $0.50 | $0.50 | $0.50 |
Where Maine sits
The same service costs 4.7 times more in Florida 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· 18th of 51
$10.96
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.