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 $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $14.45 Typical High $27.54 | Facility | None | $11.22 | $14.45 | $27.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.55 Median $11.75 Typical High $13.49 | Professional | None | $9.55 | $11.75 | $13.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.87 Median $1.17 Typical High $1.29 | Professional | RR · Rental | $0.87 | $1.17 | $1.29 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $6.61 Median $8.91 Typical High $9.77 | Professional | UE · Used equipment | $6.61 | $8.91 | $9.77 |
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 $4.90 Median $10.47 Typical High $16.22 | Professional | None | $4.90 | $10.47 | $16.22 |
Martin's Point Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
United Setting Professional Modifier None Typical Low $4.57 Median $12.88 Typical High $16.22 | Professional | None | $4.57 | $12.88 | $16.22 |
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 $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.78 Typical High $0.78 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.78 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.52 | $0.52 | $0.52 |
Where Maine sits
The same service costs 4.6 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· 10th of 51
$11.48
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.