How much rates vary
Facilitymedian $1,259 · 10th to 90th $708 to $2,951Professionalmedian $603 · 10th to 90th $170 to $2,570
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 Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $2,570.40 | Professional | None | $158.49 | $269.15 | $2,570.40 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $602.56 Typical High $2,398.83 | Professional | None | $144.54 | $602.56 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $891.25 Typical High $3,630.78 | Professional | 50 · Both sides | $223.87 | $891.25 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,513.56 Typical High $5,754.40 | Facility | None | $707.95 | $1,513.56 | $5,754.40 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $323.59 Typical High $2,511.89 | Professional | None | $204.17 | $323.59 | $2,511.89 |
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 $194.98 Median $288.40 Typical High $2,691.53 | Professional | None | $194.98 | $288.40 | $2,691.53 |
Martin's Point Setting Professional Modifier None Typical Low $158.49 Median $269.15 Typical High $2,570.40 | Professional | None | $158.49 | $269.15 | $2,570.40 |
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 $204.17 Median $288.40 Typical High $2,754.23 | Professional | None | $204.17 | $288.40 | $2,754.23 |
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 $114.82 Median $114.82 Typical High $1,288.25 | Professional | 52 · Reduced service | $114.82 | $114.82 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $512.86 | Professional | 53 · Discontinued | $46.77 | $46.77 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $1,949.84 | Professional | 54 · Surgery only | $173.78 | $173.78 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $389.05 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $257.04 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $257.04 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $114.82 Median $114.82 Typical High $1,288.25 | Professional | 52 · Reduced service | $114.82 | $114.82 | $1,288.25 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $46.77 Typical High $512.86 | Professional | 53 · Discontinued | $46.77 | $46.77 | $512.86 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $1,949.84 | Professional | 54 · Surgery only | $173.78 | $173.78 | $1,949.84 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $389.05 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $389.05 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $23.44 Typical High $257.04 | Professional | 56 · Pre-op care only | $23.44 | $23.44 | $257.04 |
Where Maine sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 45th of 51
$1,000
WI $2,291NE $269
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.