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 $501.19 Median $630.96 Typical High $630.96 | Professional | None | $501.19 | $630.96 | $630.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,511.89 | Facility | None | $1,047.13 | $1,318.26 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $602.56 Typical High $645.65 | Professional | None | $575.44 | $602.56 | $645.65 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $57.54 Median $57.54 Typical High $64.57 | Professional | RR · Rental | $57.54 | $57.54 | $64.57 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $436.52 Median $436.52 Typical High $478.63 | Professional | UE · Used equipment | $436.52 | $436.52 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $891.25 | Facility | None | $724.44 | $724.44 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $724.44 | Professional | None | $537.03 | $537.03 | $724.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $407.38 Median $912.01 Typical High $1,202.26 | Professional | None | $407.38 | $912.01 | $1,202.26 |
Martin's Point Setting Professional Modifier None Typical Low $602.56 Median $630.96 Typical High $630.96 | Professional | None | $602.56 | $630.96 | $630.96 |
United Setting Professional Modifier None Typical Low $407.38 Median $524.81 Typical High $1,445.44 | Professional | None | $407.38 | $524.81 | $1,445.44 |
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 $91.20 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $91.20 | $95.50 | $95.50 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $60.26 | $63.10 | $63.10 |
Where Maine sits
The same service costs 2.0 times more in Montana than in West Virginia. 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· 32nd of 51
$603
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.