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 $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Anthem BCBS Setting Facility Modifier None Typical Low $35.48 Median $44.67 Typical High $85.11 | Facility | None | $35.48 | $44.67 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.20 Median $37.15 Typical High $42.66 | Professional | None | $30.20 | $37.15 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.75 Median $3.72 Typical High $4.07 | Professional | RR · Rental | $2.75 | $3.72 | $4.07 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $20.89 Median $27.54 Typical High $30.20 | Professional | UE · Used equipment | $20.89 | $27.54 | $30.20 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | None | $21.38 | $21.38 | $21.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $15.49 Median $33.11 Typical High $50.12 | Professional | None | $15.49 | $33.11 | $50.12 |
Martin's Point Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $14.13 Median $39.81 Typical High $50.12 | Professional | None | $14.13 | $39.81 | $50.12 |
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 $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.45 Typical High $2.45 | Professional | 55 · Aftercare only | $2.45 | $2.45 | $2.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Maine sits
The same service costs 3.5 times more in Montana 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· 14th of 51
$36.31
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.