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 $77.62 Median $102.33 Typical High $102.33 | Professional | None | $77.62 | $102.33 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $147.91 Median $190.55 Typical High $363.08 | Facility | None | $147.91 | $190.55 | $363.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $102.33 | Professional | None | $93.33 | $95.50 | $102.33 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | RR · Rental | $9.33 | $9.33 | $10.23 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $69.18 Median $69.18 Typical High $75.86 | Professional | UE · Used equipment | $69.18 | $69.18 | $75.86 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $109.65 | Facility | None | $100.00 | $100.00 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $100.00 | Professional | None | $72.44 | $72.44 | $100.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $58.88 Median $131.83 Typical High $173.78 | Professional | None | $58.88 | $131.83 | $173.78 |
Martin's Point Setting Professional Modifier None Typical Low $77.62 Median $102.33 Typical High $102.33 | Professional | None | $77.62 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $58.88 Median $75.86 Typical High $208.93 | Professional | None | $58.88 | $75.86 | $208.93 |
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 $12.30 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $10.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $12.30 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $10.23 |
Where Maine sits
The same service costs 2.2 times more in Montana than in Florida. 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· 28th of 51
$95.50
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.