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 $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $588.84 Median $758.58 Typical High $1,445.44 | Facility | None | $588.84 | $758.58 | $1,445.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $426.58 Typical High $457.09 | Professional | None | $416.87 | $426.58 | $457.09 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $41.69 Median $41.69 Typical High $45.71 | Professional | RR · Rental | $41.69 | $41.69 | $45.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $309.03 Median $309.03 Typical High $338.84 | Professional | UE · Used equipment | $309.03 | $309.03 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Facility | None | $380.19 | $380.19 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $380.19 | Professional | None | $275.42 | $275.42 | $380.19 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $245.47 Median $524.81 Typical High $691.83 | Professional | None | $245.47 | $524.81 | $691.83 |
Martin's Point Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $398.11 | Professional | None | $354.81 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $831.76 | Professional | None | $234.42 | $295.12 | $831.76 |
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 $56.23 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $39.81 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $60.26 Typical High $60.26 | Professional | 55 · Aftercare only | $56.23 | $60.26 | $60.26 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $39.81 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Delaware. 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· 31st of 51
$417
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.