How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $19.05 Median $20.89 Typical High $20.89 | Professional | None | $19.05 | $20.89 | $20.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $42.66 | Professional | None | $38.90 | $38.90 | $42.66 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $3.89 Median $3.89 Typical High $4.27 | Professional | RR · Rental | $3.89 | $3.89 | $4.27 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $29.51 Median $29.51 Typical High $31.62 | Professional | UE · Used equipment | $29.51 | $29.51 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $29.51 | Facility | None | $27.54 | $27.54 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $27.54 | Professional | None | $19.95 | $19.95 | $27.54 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.45 Median $38.02 Typical High $75.86 | Professional | None | $14.45 | $38.02 | $75.86 |
Martin's Point Setting Professional Modifier None Typical Low $19.05 Median $20.89 Typical High $20.89 | Professional | None | $19.05 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $11.48 Median $17.38 Typical High $45.71 | Professional | None | $11.48 | $17.38 | $45.71 |
8 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 52 · Reduced service Typical Low $9.55 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $9.55 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.80 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $2.88 | $3.16 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.91 | $2.09 | $2.09 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $9.55 Median $10.47 Typical High $10.47 | Professional | 52 · Reduced service | $9.55 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $4.27 Typical High $4.27 | Professional | 53 · Discontinued | $3.80 | $4.27 | $4.27 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $3.16 Typical High $3.16 | Professional | 55 · Aftercare only | $2.88 | $3.16 | $3.16 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $2.09 Typical High $2.09 | Professional | 56 · Pre-op care only | $1.91 | $2.09 | $2.09 |
Where Maine sits
The same service costs 4.4 times more in Wyoming than in Colorado. 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· 7th of 51
$37.15
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.