How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $26.92 | Professional | None | $25.12 | $25.12 | $26.92 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.51 Median $2.51 Typical High $2.75 | Professional | RR · Rental | $2.51 | $2.51 | $2.75 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $18.62 Median $18.62 Typical High $20.42 | Professional | UE · Used equipment | $18.62 | $18.62 | $20.42 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $17.38 | Facility | None | $12.59 | $12.59 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $12.59 | Professional | None | $10.72 | $10.72 | $12.59 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.96 Median $17.78 Typical High $32.36 | Professional | None | $10.96 | $17.78 | $32.36 |
Martin's Point Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
United Setting Professional Modifier None Typical Low $8.91 Median $13.18 Typical High $38.90 | Professional | None | $8.91 | $13.18 | $38.90 |
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 $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $4.27 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $2.82 |
Where Maine sits
The same service costs 3.5 times more in North Dakota than in Oklahoma. 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· 5th of 51
$25.12
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.