How much rates vary
Facilitymedian $3,020 · 10th to 90th $708 to $10,233Professionalmedian $1,738 · 10th to 90th $479 to $7,943
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 $660.69 Median $660.69 Typical High $7,585.78 | Facility | None | $660.69 | $660.69 | $7,585.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $7,585.78 | Professional | None | $478.63 | $724.44 | $7,585.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $1,737.80 Typical High $7,943.28 | Professional | None | $398.11 | $1,737.80 | $7,943.28 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $7,762.47 Typical High $12,302.69 | Facility | None | $707.95 | $7,762.47 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $912.01 Typical High $8,511.38 | Professional | None | $549.54 | $912.01 | $8,511.38 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $8,317.64 | Professional | None | $537.03 | $831.76 | $8,317.64 |
Martin's Point Setting Professional Modifier None Typical Low $478.63 Median $724.44 Typical High $7,585.78 | Professional | None | $478.63 | $724.44 | $7,585.78 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $3,019.95 Typical High $10,232.93 | Facility | None | $2,818.38 | $3,019.95 | $10,232.93 |
United Setting Professional Modifier None Typical Low $616.60 Median $831.76 Typical High $7,943.28 | Professional | None | $616.60 | $831.76 | $7,943.28 |
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 $331.13 Median $331.13 Typical High $3,801.89 | Professional | 52 · Reduced service | $331.13 | $331.13 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,513.56 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $5,623.41 | Professional | 54 · Surgery only | $501.19 | $501.19 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $1,148.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $1,148.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $758.58 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $758.58 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $331.13 Median $331.13 Typical High $3,801.89 | Professional | 52 · Reduced service | $331.13 | $331.13 | $3,801.89 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $1,513.56 | Professional | 53 · Discontinued | $131.83 | $131.83 | $1,513.56 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $501.19 Typical High $5,623.41 | Professional | 54 · Surgery only | $501.19 | $501.19 | $5,623.41 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $100.00 Typical High $1,148.15 | Professional | 55 · Aftercare only | $100.00 | $100.00 | $1,148.15 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $758.58 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $758.58 |
Where Maine sits
The same service costs 4.3 times more in Alabama than in Maine. 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
AL $20,420ME $4,758
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.