How much rates vary
Facilitymedian $3,388 · 10th to 90th $708 to $22,387Professionalmedian $2,042 · 10th to 90th $562 to $10,000
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 $524.81 Median $776.25 Typical High $9,772.37 | Professional | None | $524.81 | $776.25 | $9,772.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $2,041.74 Typical High $9,549.93 | Professional | None | $478.63 | $2,041.74 | $9,549.93 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $16,595.87 Typical High $22,387.21 | Facility | None | $707.95 | $16,595.87 | $22,387.21 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $10,000.00 | Professional | None | $691.83 | $1,096.48 | $10,000.00 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $14,791.08 | Facility | None | $3,019.95 | $3,311.31 | $14,791.08 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $10,964.78 | Professional | None | $630.96 | $977.24 | $10,964.78 |
Martin's Point Setting Professional Modifier None Typical Low $524.81 Median $776.25 Typical High $9,772.37 | Professional | None | $524.81 | $776.25 | $9,772.37 |
United Setting Facility Modifier None Typical Low $3,019.95 Median $3,311.31 Typical High $14,791.08 | Facility | None | $3,019.95 | $3,311.31 | $14,791.08 |
United Setting Professional Modifier None Typical Low $691.83 Median $977.24 Typical High $10,964.78 | Professional | None | $691.83 | $977.24 | $10,964.78 |
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 $389.05 Median $389.05 Typical High $4,897.79 | Professional | 52 · Reduced service | $389.05 | $389.05 | $4,897.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $1,949.84 | Professional | 53 · Discontinued | $154.88 | $154.88 | $1,949.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $7,413.10 | Professional | 54 · Surgery only | $588.84 | $588.84 | $7,413.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $1,479.11 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $1,479.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $977.24 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $977.24 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $389.05 Median $389.05 Typical High $4,897.79 | Professional | 52 · Reduced service | $389.05 | $389.05 | $4,897.79 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $154.88 Typical High $1,949.84 | Professional | 53 · Discontinued | $154.88 | $154.88 | $1,949.84 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $588.84 Typical High $7,413.10 | Professional | 54 · Surgery only | $588.84 | $588.84 | $7,413.10 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $117.49 Typical High $1,479.11 | Professional | 55 · Aftercare only | $117.49 | $117.49 | $1,479.11 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $77.62 Typical High $977.24 | Professional | 56 · Pre-op care only | $77.62 | $77.62 | $977.24 |
Where Maine sits
The same service costs 6.1 times more in Alaska than in Vermont. 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.
Physician feeFacility fee
AK $33,081VT $5,424
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.