How much rates vary
Facilitymedian $91 · 10th to 90th $63 to $692Professionalmedian $63 · 10th to 90th $46 to $93
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 $63.10 Median $63.10 Typical High $91.20 | Facility | None | $63.10 | $63.10 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $63.10 Typical High $91.20 | Professional | None | $47.86 | $63.10 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $57.54 Typical High $77.62 | Professional | None | $38.02 | $57.54 | $77.62 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $57.54 Median $87.10 Typical High $117.49 | Professional | 50 · Both sides | $57.54 | $87.10 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $691.83 Typical High $707.95 | Facility | None | $56.23 | $691.83 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $79.43 Typical High $117.49 | Professional | None | $61.66 | $79.43 | $117.49 |
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 Typical Low $46.77 Median $70.79 Typical High $97.72 | Professional | None | $46.77 | $70.79 | $97.72 |
Martin's Point Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $91.20 | Facility | None | $46.77 | $63.10 | $91.20 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $63.10 Typical High $91.20 | Professional | None | $50.12 | $63.10 | $91.20 |
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 Typical Low $44.67 Median $66.07 Typical High $95.50 | Professional | None | $44.67 | $66.07 | $95.50 |
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 $31.62 Median $31.62 Typical High $45.71 | Professional | 52 · Reduced service | $31.62 | $31.62 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $18.20 | Professional | 53 · Discontinued | $12.59 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $69.18 | Professional | 54 · Surgery only | $47.86 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $9.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $31.62 Typical High $45.71 | Professional | 52 · Reduced service | $31.62 | $31.62 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $18.20 | Professional | 53 · Discontinued | $12.59 | $12.59 | $18.20 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $47.86 Typical High $69.18 | Professional | 54 · Surgery only | $47.86 | $47.86 | $69.18 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $9.55 Typical High $13.80 | Professional | 55 · Aftercare only | $9.55 | $9.55 | $13.80 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $6.31 | $9.12 |
Where Maine sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 35th of 51
$63.10
AK $191MD $50.12
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.