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 $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $812.83 | $1,047.13 | $1,047.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $1,949.84 Typical High $3,715.35 | Facility | None | $1,513.56 | $1,949.84 | $3,715.35 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,047.13 | Professional | None | $954.99 | $954.99 | $1,047.13 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $95.50 Median $95.50 Typical High $104.71 | Professional | RR · Rental | $95.50 | $95.50 | $104.71 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $707.95 Median $707.95 Typical High $794.33 | Professional | UE · Used equipment | $707.95 | $707.95 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,122.02 Typical High $1,202.26 | Facility | None | $1,122.02 | $1,122.02 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $1,122.02 | Professional | None | $812.83 | $812.83 | $1,122.02 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $602.56 Median $1,348.96 Typical High $1,778.28 | Professional | None | $602.56 | $1,348.96 | $1,778.28 |
Martin's Point Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,047.13 | Professional | None | $812.83 | $1,047.13 | $1,047.13 |
United Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $2,137.96 | Professional | None | $602.56 | $776.25 | $2,137.96 |
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 $128.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $154.88 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $154.88 | $154.88 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $85.11 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $85.11 | $104.71 | $104.71 |
Where Maine sits
The same service costs 2.1 times more in Montana than in West Virginia. 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
$977
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.