How much rates vary
Facilitymedian $832 · 10th to 90th $191 to $1,380Professionalmedian $309 · 10th to 90th $174 to $589
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 $190.55 Median $190.55 Typical High $371.54 | Facility | None | $190.55 | $190.55 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $489.78 | Professional | None | $190.55 | $275.42 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $93.33 Typical High $218.78 | Professional | 53 · Discontinued | $38.02 | $93.33 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Facility | None | $1,023.29 | $1,023.29 | $1,023.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $331.13 Typical High $602.56 | Professional | None | $177.83 | $331.13 | $602.56 |
Anthem BCBS Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $147.91 Typical High $288.40 | Professional | 53 · Discontinued | $77.62 | $147.91 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $691.83 Typical High $1,412.54 | Facility | None | $537.03 | $691.83 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $354.81 Typical High $588.84 | Professional | None | $213.80 | $354.81 | $588.84 |
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 $173.78 Median $309.03 Typical High $645.65 | Professional | None | $173.78 | $309.03 | $645.65 |
Martin's Point Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $489.78 | Professional | None | $190.55 | $275.42 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $93.33 Typical High $218.78 | Professional | 53 · Discontinued | $38.02 | $93.33 | $218.78 |
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 $158.49 Median $302.00 Typical High $588.84 | Professional | None | $158.49 | $302.00 | $588.84 |
8 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 $93.33 Median $144.54 Typical High $181.97 | Professional | 52 · Reduced service | $93.33 | $144.54 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $141.25 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $28.84 | $37.15 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $93.33 Median $144.54 Typical High $181.97 | Professional | 52 · Reduced service | $93.33 | $144.54 | $181.97 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $141.25 | $218.78 | $275.42 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $43.65 Typical High $54.95 | Professional | 55 · Aftercare only | $28.18 | $43.65 | $54.95 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $28.84 | $37.15 |
Where Maine sits
The same service costs 4.7 times more in Connecticut than in North Dakota. 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
CT $3,190ND $672
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.