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 $40.74 Median $50.12 Typical High $50.12 | Professional | None | $40.74 | $50.12 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $74.13 Median $93.33 Typical High $177.83 | Facility | None | $74.13 | $93.33 | $177.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | None | $42.66 | $42.66 | $46.77 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $4.27 Median $4.27 Typical High $4.68 | Professional | RR · Rental | $4.27 | $4.27 | $4.68 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $31.62 Median $31.62 Typical High $34.67 | Professional | UE · Used equipment | $31.62 | $31.62 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $46.77 | Facility | None | $43.65 | $43.65 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $28.84 Median $64.57 Typical High $85.11 | Professional | None | $28.84 | $64.57 | $85.11 |
Martin's Point Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $50.12 | Professional | None | $40.74 | $50.12 | $50.12 |
United Setting Professional Modifier None Typical Low $28.84 Median $37.15 Typical High $102.33 | Professional | None | $28.84 | $37.15 | $102.33 |
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 $6.17 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.07 | $5.01 | $5.01 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.59 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $7.59 | $7.59 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.07 | $5.01 | $5.01 |
Where Maine sits
The same service costs 2.2 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· 31st of 51
$42.66
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.