How much rates vary
Facilitymedian $501 · 10th to 90th $74 to $708Professionalmedian $117 · 10th to 90th $83 to $174
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 $93.33 Median $93.33 Typical High $165.96 | Professional | None (both parts) | $93.33 | $93.33 | $165.96 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $45.71 Median $52.48 Typical High $77.62 | Professional | 26 · Professional part | $45.71 | $52.48 | $77.62 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $40.74 Typical High $87.10 | Professional | TC · Technical part | $40.74 | $40.74 | $87.10 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $77.62 Median $123.03 Typical High $165.96 | Professional | None (both parts) | $77.62 | $123.03 | $165.96 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $66.07 Typical High $87.10 | Professional | 26 · Professional part | $44.67 | $66.07 | $87.10 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $56.23 Typical High $87.10 | Professional | TC · Technical part | $39.81 | $56.23 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $141.25 Typical High $1,412.54 | Facility | None | $61.66 | $141.25 | $1,412.54 |
Cigna Setting Professional Modifier None (both parts) Typical Low $102.33 Median $107.15 Typical High $194.98 | Professional | None (both parts) | $102.33 | $107.15 | $194.98 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $57.54 Typical High $97.72 | Professional | 26 · Professional part | $54.95 | $57.54 | $97.72 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $46.77 Median $51.29 Typical High $95.50 | Professional | TC · Technical part | $46.77 | $51.29 | $95.50 |
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 $100.00 Median $128.82 Typical High $199.53 | Professional | None (both parts) | $100.00 | $128.82 | $199.53 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $57.54 Median $70.79 Typical High $100.00 | Professional | 26 · Professional part | $57.54 | $70.79 | $100.00 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $48.98 Median $67.61 Typical High $104.71 | Professional | TC · Technical part | $48.98 | $67.61 | $104.71 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $93.33 Median $93.33 Typical High $165.96 | Professional | None (both parts) | $93.33 | $93.33 | $165.96 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $52.48 Typical High $77.62 | Professional | 26 · Professional part | $44.67 | $52.48 | $77.62 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $40.74 Typical High $87.10 | Professional | TC · Technical part | $40.74 | $40.74 | $87.10 |
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 $100.00 Median $120.23 Typical High $169.82 | Professional | None (both parts) | $100.00 | $120.23 | $169.82 |
United Setting Professional Modifier 26 · Professional part Typical Low $54.95 Median $70.79 Typical High $87.10 | Professional | 26 · Professional part | $54.95 | $70.79 | $87.10 |
United Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $54.95 Typical High $83.18 | Professional | TC · Technical part | $41.69 | $54.95 | $83.18 |
4 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 $46.77 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $9.33 | $9.33 | $9.33 |
Where Maine sits
The same service costs 5.9 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· 26th of 51
$120
AK $331AL $56.23
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.