How much rates vary
Facilitymedian $501 · 10th to 90th $19 to $708Professionalmedian $170 · 10th to 90th $123 to $234
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 (both parts) Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None (both parts) | $123.03 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | 26 · Professional part | $109.65 | $109.65 | $109.65 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | TC · Technical part | $12.30 | $12.30 | $12.30 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $117.49 Median $173.78 Typical High $229.09 | Professional | None (both parts) | $117.49 | $173.78 | $229.09 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $102.33 Median $151.36 Typical High $204.17 | Professional | 26 · Professional part | $102.33 | $151.36 | $204.17 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $12.59 Median $18.62 Typical High $28.18 | Professional | TC · Technical part | $12.59 | $18.62 | $28.18 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $37.15 Typical High $707.95 | Facility | None | $16.60 | $37.15 | $707.95 |
Cigna Setting Professional Modifier None (both parts) Typical Low $162.18 Median $169.82 Typical High $269.15 | Professional | None (both parts) | $162.18 | $169.82 | $269.15 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $144.54 Median $147.91 Typical High $239.88 | Professional | 26 · Professional part | $144.54 | $147.91 | $239.88 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $18.62 Median $19.95 Typical High $33.11 | Professional | TC · Technical part | $18.62 | $19.95 | $33.11 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $151.36 Median $177.83 Typical High $245.47 | Professional | None (both parts) | $151.36 | $177.83 | $245.47 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $134.90 Median $173.78 Typical High $234.42 | Professional | 26 · Professional part | $134.90 | $173.78 | $234.42 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $13.49 Median $18.20 Typical High $28.18 | Professional | TC · Technical part | $13.49 | $18.20 | $28.18 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None (both parts) | $123.03 | $123.03 | $123.03 |
United Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $707.95 | Facility | None | $338.84 | $524.81 | $707.95 |
United Setting Professional Modifier None (both parts) Typical Low $141.25 Median $190.55 Typical High $245.47 | Professional | None (both parts) | $141.25 | $190.55 | $245.47 |
United Setting Professional Modifier 26 · Professional part Typical Low $131.83 Median $173.78 Typical High $213.80 | Professional | 26 · Professional part | $131.83 | $173.78 | $213.80 |
United Setting Professional Modifier TC · Technical part Typical Low $12.59 Median $16.98 Typical High $30.20 | Professional | TC · Technical part | $12.59 | $16.98 | $30.20 |
5 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 $61.66 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $24.55 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | 54 · Surgery only | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $18.20 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.30 |
Where Maine sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 21st of 51
$170
AK $490AL $105
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.