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 $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $1.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.90 Median $39.81 Typical High $74.13 | Facility | None | $30.90 | $39.81 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $11.48 Typical High $11.48 | Professional | None | $8.91 | $11.48 | $11.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.79 Median $27.54 Typical High $27.54 | Professional | None | $14.79 | $27.54 | $27.54 |
Martin's Point Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $8.91 Median $8.91 Typical High $8.91 | Professional | 52 · Reduced service | $8.91 | $8.91 | $8.91 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | 53 · Discontinued | $3.55 | $3.55 | $3.55 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $2.69 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $1.78 Typical High $1.78 | Professional | 56 · Pre-op care only | $1.78 | $1.78 | $1.78 |
United Setting Professional Modifier None Typical Low $14.79 Median $15.49 Typical High $15.49 | Professional | None | $14.79 | $15.49 | $15.49 |
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 $3.16 Median $3.16 Typical High $3.16 | Professional | RR · Rental | $3.16 | $3.16 | $3.16 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | UE · Used equipment | $23.99 | $23.99 | $23.99 |
Where Maine sits
The same service costs 4.6 times more in Hawaii than in Ohio. 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
$17.78
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.