How much rates vary
Facilitymedian $339 · 10th to 90th $115 to $617Professionalmedian $145 · 10th to 90th $95 to $191
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 $151.36 Median $151.36 Typical High $154.88 | Facility | None | $151.36 | $151.36 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $190.55 | Professional | None | $104.71 | $151.36 | $190.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $173.78 | Professional | None | $77.62 | $120.23 | $173.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $128.82 Median $177.83 Typical High $257.04 | Professional | 50 · Both sides | $128.82 | $177.83 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $165.96 Typical High $1,412.54 | Facility | None | $74.13 | $165.96 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $218.78 | Professional | None | $138.04 | $173.78 | $218.78 |
Community Health Options Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
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 $93.33 Median $141.25 Typical High $181.97 | Professional | None | $93.33 | $141.25 | $181.97 |
Martin's Point Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $190.55 | Professional | None | $104.71 | $151.36 | $190.55 |
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 $97.72 Median $141.25 Typical High $181.97 | Professional | None | $97.72 | $141.25 | $181.97 |
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 $75.86 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $75.86 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 54 · Surgery only | $112.20 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.49 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $75.86 Median $75.86 Typical High $77.62 | Professional | 52 · Reduced service | $75.86 | $75.86 | $77.62 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | 53 · Discontinued | $30.20 | $30.20 | $30.90 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $112.20 Typical High $117.49 | Professional | 54 · Surgery only | $112.20 | $112.20 | $117.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $23.44 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $23.44 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $15.14 Typical High $15.49 | Professional | 56 · Pre-op care only | $15.14 | $15.14 | $15.49 |
Where Maine sits
The same service costs 3.7 times more in Alaska than in Florida. 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· 30th of 51
$145
AK $363FL $97.72
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.