How much rates vary
Professionalmedian $76 · 10th to 90th $59 to $110
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 (both parts) Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 26 · Professional part | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | TC · Technical part | $46.77 | $46.77 | $46.77 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $47.86 Median $58.88 Typical High $67.61 | Professional | None (both parts) | $47.86 | $58.88 | $67.61 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $21.38 Median $25.12 Typical High $31.62 | Professional | 26 · Professional part | $21.38 | $25.12 | $31.62 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $29.51 Median $34.67 Typical High $42.66 | Professional | TC · Technical part | $29.51 | $34.67 | $42.66 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $91.20 Median $91.20 Typical High $141.25 | Professional | None (both parts) | $91.20 | $91.20 | $141.25 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $34.67 Typical High $53.70 | Professional | 26 · Professional part | $34.67 | $34.67 | $53.70 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $57.54 Median $57.54 Typical High $87.10 | Professional | TC · Technical part | $57.54 | $57.54 | $87.10 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | None (both parts) | $75.86 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | 26 · Professional part | $28.84 | $28.84 | $28.84 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | TC · Technical part | $46.77 | $46.77 | $46.77 |
United Setting Professional Modifier None (both parts) Typical Low $72.44 Median $107.15 Typical High $144.54 | Professional | None (both parts) | $72.44 | $107.15 | $144.54 |
United Setting Professional Modifier 26 · Professional part Typical Low $29.51 Median $41.69 Typical High $66.07 | Professional | 26 · Professional part | $29.51 | $41.69 | $66.07 |
United Setting Professional Modifier TC · Technical part Typical Low $43.65 Median $64.57 Typical High $81.28 | Professional | TC · Technical part | $43.65 | $64.57 | $81.28 |
10 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 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 54 · Surgery only | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 52 · Reduced service | $38.02 | $38.02 | $38.02 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | 53 · Discontinued | $15.14 | $15.14 | $15.14 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $56.23 Typical High $56.23 | Professional | 54 · Surgery only | $56.23 | $56.23 | $56.23 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $11.22 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $7.59 |
Where Maine sits
The same service costs 4.4 times more in Texas 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· 32nd of 51
$75.86
TX $174NY $39.81
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.