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 $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $12.02 Median $15.49 Typical High $29.51 | Facility | None | $12.02 | $15.49 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $4.79 Median $6.03 Typical High $6.03 | Professional | None | $4.79 | $6.03 | $6.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $5.89 Median $10.72 Typical High $10.72 | Professional | None | $5.89 | $10.72 | $10.72 |
Martin's Point Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | None | $7.08 | $7.08 | $7.08 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 52 · Reduced service | $3.55 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $1.41 | Professional | 53 · Discontinued | $1.41 | $1.41 | $1.41 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $1.07 | $1.07 | $1.07 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.71 | $0.71 | $0.71 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.17 Typical High $6.17 | Professional | None | $4.79 | $6.17 | $6.17 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.70 Median $1.70 Typical High $1.70 | Professional | RR · Rental | $1.70 | $1.70 | $1.70 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | UE · Used equipment | $12.59 | $12.59 | $12.59 |
Where Maine sits
The same service costs 2.7 times more in Montana than in Utah. 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· 39th of 51
$7.08
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.