How much rates vary
Facilitymedian $525 · 10th to 90th $501 to $1,000Professionalmedian $331 · 10th to 90th $200 to $501
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 Typical Low $263.03 Median $501.19 Typical High $501.19 | Professional | None | $263.03 | $501.19 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $257.04 Typical High $380.19 | Professional | None | $186.21 | $257.04 | $380.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $281.84 Median $380.19 Typical High $575.44 | Professional | 50 · Both sides | $281.84 | $380.19 | $575.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $117.49 Median $162.18 Typical High $239.88 | Professional | 62 · Two surgeons | $117.49 | $162.18 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,000.00 Typical High $2,290.87 | Facility | None | $870.96 | $1,000.00 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $407.38 Typical High $446.68 | Professional | None | $316.23 | $407.38 | $446.68 |
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 $199.53 Median $331.13 Typical High $562.34 | Professional | None | $199.53 | $331.13 | $562.34 |
Martin's Point Setting Professional Modifier None Typical Low $263.03 Median $501.19 Typical High $501.19 | Professional | None | $263.03 | $501.19 | $501.19 |
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 $323.59 Median $446.68 Typical High $562.34 | Professional | None | $323.59 | $446.68 | $562.34 |
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 $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $251.19 | $251.19 | $251.19 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | 53 · Discontinued | $102.33 | $102.33 | $102.33 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | 54 · Surgery only | $380.19 | $380.19 | $380.19 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $75.86 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $50.12 |
Where Maine sits
The same service costs 10.8 times more in New York 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.
Physician feeFacility fee
NY $4,667MD $433
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.