How much rates vary
Facilitymedian $229 · 10th to 90th $69 to $708Professionalmedian $98 · 10th to 90th $62 to $269
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 $69.18 Median $177.83 Typical High $229.09 | Facility | None | $69.18 | $177.83 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $269.15 | Professional | None | $69.18 | $97.72 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $165.96 | Professional | None | $50.12 | $79.43 | $165.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $120.23 Typical High $162.18 | Professional | 50 · Both sides | $75.86 | $120.23 | $162.18 |
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 $72.44 Median $128.82 Typical High $302.00 | Professional | None | $72.44 | $128.82 | $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 $61.66 Median $117.49 Typical High $316.23 | Professional | None | $61.66 | $117.49 | $316.23 |
Martin's Point Setting Facility Modifier None Typical Low $69.18 Median $177.83 Typical High $23,442.29 | Facility | None | $69.18 | $177.83 | $23,442.29 |
Martin's Point Setting Professional Modifier None Typical Low $69.18 Median $97.72 Typical High $269.15 | Professional | None | $69.18 | $97.72 | $269.15 |
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 $74.13 Median $112.20 Typical High $239.88 | Professional | None | $74.13 | $112.20 | $239.88 |
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 $34.67 Median $34.67 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $34.67 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $13.80 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $131.83 | Professional | 54 · Surgery only | $52.48 | $52.48 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $17.78 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $34.67 Typical High $89.13 | Professional | 52 · Reduced service | $34.67 | $34.67 | $89.13 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $13.80 Typical High $35.48 | Professional | 53 · Discontinued | $13.80 | $13.80 | $35.48 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $52.48 Typical High $131.83 | Professional | 54 · Surgery only | $52.48 | $52.48 | $131.83 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $26.92 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $26.92 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $17.78 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $17.78 |
Where Maine sits
The same service costs 4.0 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· 46th of 51
$97.72
AK $316KY $79.43
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.