How much rates vary
Facilitymedian $708 · 10th to 90th $129 to $10,965Professionalmedian $148 · 10th to 90th $85 to $275
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 $10,964.78 Median $10,964.78 Typical High $20,417.38 | Facility | None | $10,964.78 | $10,964.78 | $20,417.38 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $204.17 | Professional | None | $75.86 | $114.82 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $147.91 Typical High $269.15 | Professional | None | $85.11 | $147.91 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $204.17 Typical High $1,412.54 | Facility | None | $91.20 | $204.17 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $275.42 | Professional | None | $102.33 | $162.18 | $275.42 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $281.84 | Professional | None | $114.82 | $177.83 | $281.84 |
Martin's Point Setting Facility Modifier None Typical Low $10,964.78 Median $10,964.78 Typical High $20,417.38 | Facility | None | $10,964.78 | $10,964.78 | $20,417.38 |
Martin's Point Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $204.17 | Professional | None | $75.86 | $114.82 | $204.17 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $257.04 | Professional | None | $123.03 | $177.83 | $257.04 |
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 $45.71 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $45.71 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $22.91 | Professional | 53 · Discontinued | $15.14 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | 54 · Surgery only | $56.23 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $11.48 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $45.71 Typical High $57.54 | Professional | 52 · Reduced service | $38.02 | $45.71 | $57.54 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $22.91 | Professional | 53 · Discontinued | $15.14 | $18.20 | $22.91 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $69.18 Typical High $87.10 | Professional | 54 · Surgery only | $56.23 | $69.18 | $87.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.80 Typical High $17.38 | Professional | 55 · Aftercare only | $11.22 | $13.80 | $17.38 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $11.48 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $11.48 |
Where Maine sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 29th of 51
$148
AK $372FL $117
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.