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 $1,905.46 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,511.89 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,630.78 Median $4,677.35 Typical High $8,912.51 | Facility | None | $3,630.78 | $4,677.35 | $8,912.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,290.87 | Professional | None | $2,089.30 | $2,089.30 | $2,290.87 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $208.93 Median $208.93 Typical High $229.09 | Professional | RR · Rental | $208.93 | $208.93 | $229.09 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $1,548.82 Median $1,548.82 Typical High $1,698.24 | Professional | UE · Used equipment | $1,548.82 | $1,548.82 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,754.23 | Facility | None | $2,454.71 | $2,454.71 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,778.28 | $1,778.28 | $2,454.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,445.44 Median $3,235.94 Typical High $4,265.80 | Professional | None | $1,445.44 | $3,235.94 | $4,265.80 |
Martin's Point Setting Professional Modifier None Typical Low $1,905.46 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,905.46 | $2,511.89 | $2,511.89 |
United Setting Professional Modifier None Typical Low $1,445.44 Median $1,862.09 Typical High $5,128.61 | Professional | None | $1,445.44 | $1,862.09 | $5,128.61 |
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 $309.03 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $204.17 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $309.03 Median $371.54 Typical High $371.54 | Professional | 55 · Aftercare only | $309.03 | $371.54 | $371.54 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $204.17 Median $251.19 Typical High $251.19 | Professional | 56 · Pre-op care only | $204.17 | $251.19 | $251.19 |
Where Maine sits
The same service costs 2.3 times more in Montana 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
$2,239
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.