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 Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $354.81 | Professional | None | $141.25 | $173.78 | $354.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $158.49 | Professional | None | $107.15 | $141.25 | $158.49 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $10.72 Median $14.13 Typical High $15.85 | Professional | RR · Rental | $10.72 | $14.13 | $15.85 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $79.43 Median $107.15 Typical High $117.49 | Professional | UE · Used equipment | $79.43 | $107.15 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $194.98 Typical High $194.98 | Facility | None | $181.97 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $194.98 | Professional | None | $165.96 | $165.96 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $100.00 Median $223.87 Typical High $295.12 | Professional | None | $100.00 | $223.87 | $295.12 |
Martin's Point Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
Martin's Point Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $354.81 | Professional | None | $141.25 | $173.78 | $354.81 |
United Setting Professional Modifier None Typical Low $100.00 Median $128.82 Typical High $354.81 | Professional | None | $100.00 | $128.82 | $354.81 |
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 $21.38 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $21.38 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.13 | $17.38 | $17.38 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.30 Typical High $26.30 | Professional | 55 · Aftercare only | $21.38 | $26.30 | $26.30 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $14.13 | $17.38 | $17.38 |
Where Maine sits
The same service costs 2.6 times more in Montana than in New York. 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· 40th of 51
$166
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.