How much rates vary
Facilitymedian $68 · 10th to 90th $30 to $617Professionalmedian $71 · 10th to 90th $35 to $148
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 $29.51 Median $41.69 Typical High $67.61 | Facility | None | $29.51 | $41.69 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $67.61 Typical High $147.91 | Professional | None | $29.51 | $67.61 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $144.54 | Professional | None | $38.02 | $74.13 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $87.10 Typical High $165.96 | Professional | None | $41.69 | $87.10 | $165.96 |
Community Health Options Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $144.54 | Professional | None | $44.67 | $79.43 | $144.54 |
Martin's Point Setting Facility Modifier None Typical Low $29.51 Median $41.69 Typical High $107.15 | Facility | None | $29.51 | $41.69 | $107.15 |
Martin's Point Setting Professional Modifier None Typical Low $29.51 Median $67.61 Typical High $147.91 | Professional | None | $29.51 | $67.61 | $147.91 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None Typical Low $47.86 Median $79.43 Typical High $138.04 | Professional | None | $47.86 | $79.43 | $138.04 |
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 $14.79 Median $19.05 Typical High $33.88 | Professional | 52 · Reduced service | $14.79 | $19.05 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.59 Typical High $13.80 | Professional | 53 · Discontinued | $5.89 | $7.59 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $28.84 Typical High $51.29 | Professional | 54 · Surgery only | $22.39 | $28.84 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.75 Typical High $10.23 | Professional | 55 · Aftercare only | $4.47 | $5.75 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.80 Typical High $6.76 | Professional | 56 · Pre-op care only | $2.95 | $3.80 | $6.76 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $14.79 Median $19.05 Typical High $33.88 | Professional | 52 · Reduced service | $14.79 | $19.05 | $33.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.59 Typical High $13.80 | Professional | 53 · Discontinued | $5.89 | $7.59 | $13.80 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $28.84 Typical High $51.29 | Professional | 54 · Surgery only | $22.39 | $28.84 | $51.29 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.75 Typical High $10.23 | Professional | 55 · Aftercare only | $4.47 | $5.75 | $10.23 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.80 Typical High $6.76 | Professional | 56 · Pre-op care only | $2.95 | $3.80 | $6.76 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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· 42nd of 51
$69.18
AK $178KY $47.86
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.