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 $660.69 Median $851.14 Typical High $851.14 | Professional | None | $660.69 | $851.14 | $851.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $3,019.95 | Facility | None | $1,258.93 | $1,621.81 | $3,019.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $776.25 Median $794.33 Typical High $851.14 | Professional | None | $776.25 | $794.33 | $851.14 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $77.62 Median $77.62 Typical High $85.11 | Professional | RR · Rental | $77.62 | $77.62 | $85.11 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $588.84 Median $588.84 Typical High $645.65 | Professional | UE · Used equipment | $588.84 | $588.84 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $724.44 Typical High $933.25 | Facility | None | $724.44 | $724.44 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $724.44 | Professional | None | $524.81 | $524.81 | $724.44 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $489.78 Median $1,096.48 Typical High $1,445.44 | Professional | None | $489.78 | $1,096.48 | $1,445.44 |
Martin's Point Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | None | $660.69 | $851.14 | $851.14 |
United Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,737.80 | Professional | None | $489.78 | $630.96 | $1,737.80 |
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 $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $128.82 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $128.82 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $85.11 |
Where Maine sits
The same service costs 2.4 times more in Hawaii 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· 27th of 51
$794
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.