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 $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.46 Median $8.32 Typical High $15.85 | Facility | None | $6.46 | $8.32 | $15.85 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.62 Median $6.92 Typical High $7.94 | Professional | None | $5.62 | $6.92 | $7.94 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.51 Median $0.69 Typical High $0.76 | Professional | RR · Rental | $0.51 | $0.69 | $0.76 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.89 Median $5.13 Typical High $5.62 | Professional | UE · Used equipment | $3.89 | $5.13 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.88 Median $6.17 Typical High $9.33 | Professional | None | $2.88 | $6.17 | $9.33 |
Martin's Point Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.02 | Professional | None | $3.02 | $3.02 | $3.02 |
United Setting Professional Modifier None Typical Low $2.63 Median $7.41 Typical High $9.33 | Professional | None | $2.63 | $7.41 | $9.33 |
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 $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.45 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.30 |
Where Maine sits
The same service costs 83.2 times more in Kansas than in Indiana. 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
$6.61
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.