How much rates vary
Facilitymedian $98 · 10th to 90th $50 to $1,202Professionalmedian $76 · 10th to 90th $41 to $132
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 $50.12 Median $89.13 Typical High $100.00 | Facility | None | $50.12 | $89.13 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $131.83 | Professional | None | $50.12 | $89.13 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $48.98 Typical High $89.13 | Professional | None | $38.02 | $48.98 | $89.13 |
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 Typical Low $52.48 Median $93.33 Typical High $138.04 | Professional | None | $52.48 | $93.33 | $138.04 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $151.36 | Professional | None | $47.86 | $77.62 | $151.36 |
Martin's Point Setting Facility Modifier None Typical Low $48.98 Median $89.13 Typical High $11,481.54 | Facility | None | $48.98 | $89.13 | $11,481.54 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $89.13 Typical High $131.83 | Professional | None | $50.12 | $89.13 | $131.83 |
United Setting Facility Modifier None Typical Low $416.87 Median $741.31 Typical High $1,202.26 | Facility | None | $416.87 | $741.31 | $1,202.26 |
United Setting Professional Modifier None Typical Low $43.65 Median $77.62 Typical High $131.83 | Professional | None | $43.65 | $77.62 | $131.83 |
11 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 $25.12 Median $29.51 Typical High $44.67 | Professional | 52 · Reduced service | $25.12 | $29.51 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.02 Typical High $18.20 | Professional | 53 · Discontinued | $10.00 | $12.02 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $44.67 Typical High $67.61 | Professional | 54 · Surgery only | $38.02 | $44.67 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.91 Typical High $13.49 | Professional | 55 · Aftercare only | $7.59 | $8.91 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.89 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.01 | $5.89 | $8.91 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $60.26 Median $70.79 Typical High $134.90 | Professional | 50 · Both sides | $60.26 | $70.79 | $134.90 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $29.51 Typical High $44.67 | Professional | 52 · Reduced service | $25.12 | $29.51 | $44.67 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $12.02 Typical High $18.20 | Professional | 53 · Discontinued | $10.00 | $12.02 | $18.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $44.67 Typical High $67.61 | Professional | 54 · Surgery only | $38.02 | $44.67 | $67.61 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $8.91 Typical High $13.49 | Professional | 55 · Aftercare only | $7.59 | $8.91 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.89 Typical High $8.91 | Professional | 56 · Pre-op care only | $5.01 | $5.89 | $8.91 |
Where Maine sits
The same service costs 3.5 times more in Alaska than in Virginia. 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· 41st of 51
$75.86
AK $204VA $58.88
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.