How much rates vary
Facilitymedian $933 · 10th to 90th $204 to $1,413Professionalmedian $295 · 10th to 90th $191 to $479
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 $204.17 Median $204.17 Typical High $309.03 | Facility | None | $204.17 | $204.17 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $426.58 | Professional | None | $204.17 | $281.84 | $426.58 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $295.12 Typical High $478.63 | Professional | None | $162.18 | $295.12 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $269.15 Median $436.52 Typical High $724.44 | Professional | 50 · Both sides | $269.15 | $436.52 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,148.15 Typical High $1,513.56 | Facility | None | $537.03 | $1,148.15 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $331.13 Typical High $489.78 | Professional | None | $213.80 | $331.13 | $489.78 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $181.97 Median $323.59 Typical High $489.78 | Professional | None | $181.97 | $323.59 | $489.78 |
Martin's Point Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $426.58 | Professional | None | $204.17 | $281.84 | $426.58 |
United Setting Facility Modifier None Typical Low $933.25 Median $1,258.93 Typical High $1,584.89 | Facility | None | $933.25 | $1,258.93 | $1,584.89 |
United Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $436.52 | Professional | None | $229.09 | $323.59 | $436.52 |
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 $102.33 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $40.74 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $154.88 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $30.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $102.33 Typical High $154.88 | Professional | 52 · Reduced service | $102.33 | $102.33 | $154.88 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $61.66 | Professional | 53 · Discontinued | $40.74 | $40.74 | $61.66 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $229.09 | Professional | 54 · Surgery only | $154.88 | $154.88 | $229.09 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $45.71 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $45.71 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $30.90 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $30.90 |
Where Maine sits
The same service costs 3.1 times more in Alaska 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· 41st of 51
$295
AK $794NY $257
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.