How much rates vary
Professionalmedian $170 · 10th to 90th $141 to $269
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $158.49 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 26 · Professional part | $41.69 | $41.69 | $41.69 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | TC · Technical part | $117.49 | $117.49 | $117.49 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $120.23 Median $177.83 Typical High $331.13 | Professional | None (both parts) | $120.23 | $177.83 | $331.13 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $34.67 Median $51.29 Typical High $77.62 | Professional | 26 · Professional part | $34.67 | $51.29 | $77.62 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $87.10 Median $125.89 Typical High $251.19 | Professional | TC · Technical part | $87.10 | $125.89 | $251.19 |
Cigna Setting Professional Modifier None (both parts) Typical Low $177.83 Median $177.83 Typical High $288.40 | Professional | None (both parts) | $177.83 | $177.83 | $288.40 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $53.70 Typical High $70.79 | Professional | 26 · Professional part | $46.77 | $53.70 | $70.79 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $123.03 Typical High $208.93 | Professional | TC · Technical part | $123.03 | $123.03 | $208.93 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $169.82 Median $169.82 Typical High $269.15 | Professional | None (both parts) | $169.82 | $169.82 | $269.15 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $46.77 Median $46.77 Typical High $70.79 | Professional | 26 · Professional part | $46.77 | $46.77 | $70.79 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $123.03 Median $123.03 Typical High $199.53 | Professional | TC · Technical part | $123.03 | $123.03 | $199.53 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None (both parts) | $158.49 | $158.49 | $158.49 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | 26 · Professional part | $41.69 | $41.69 | $41.69 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | TC · Technical part | $117.49 | $117.49 | $117.49 |
United Setting Professional Modifier None (both parts) Typical Low $144.54 Median $269.15 Typical High $269.15 | Professional | None (both parts) | $144.54 | $269.15 | $269.15 |
United Setting Professional Modifier 26 · Professional part Typical Low $37.15 Median $52.48 Typical High $74.13 | Professional | 26 · Professional part | $37.15 | $52.48 | $74.13 |
United Setting Professional Modifier TC · Technical part Typical Low $95.50 Median $162.18 Typical High $204.17 | Professional | TC · Technical part | $95.50 | $162.18 | $204.17 |
8 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 $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $31.62 | $31.62 | $31.62 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Where Maine sits
The same service costs 3.2 times more in Kansas than in Utah. 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· 32nd of 51
$170
KS $324UT $100
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.