How much rates vary
Professionalmedian $107 · 10th to 90th $95 to $151
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 $104.71 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 26 · Professional part | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | TC · Technical part | $36.31 | $36.31 | $36.31 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $81.28 Median $107.15 Typical High $131.83 | Professional | None (both parts) | $81.28 | $107.15 | $131.83 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $69.18 Typical High $87.10 | Professional | 26 · Professional part | $58.88 | $69.18 | $87.10 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $40.74 Typical High $51.29 | Professional | TC · Technical part | $34.67 | $40.74 | $51.29 |
Cigna Setting Professional Modifier None (both parts) Typical Low $144.54 Median $144.54 Typical High $213.80 | Professional | None (both parts) | $144.54 | $144.54 | $213.80 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $93.33 Median $93.33 Typical High $138.04 | Professional | 26 · Professional part | $93.33 | $93.33 | $138.04 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $50.12 Typical High $74.13 | Professional | TC · Technical part | $50.12 | $50.12 | $74.13 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $109.65 Median $147.91 Typical High $229.09 | Professional | None (both parts) | $109.65 | $147.91 | $229.09 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $95.50 Typical High $147.91 | Professional | 26 · Professional part | $58.88 | $95.50 | $147.91 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $50.12 Median $51.29 Typical High $79.43 | Professional | TC · Technical part | $50.12 | $51.29 | $79.43 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | None (both parts) | $104.71 | $104.71 | $104.71 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 26 · Professional part | $67.61 | $67.61 | $67.61 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | TC · Technical part | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None (both parts) Typical Low $81.28 Median $123.03 Typical High $186.21 | Professional | None (both parts) | $81.28 | $123.03 | $186.21 |
United Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $66.07 Typical High $114.82 | Professional | 26 · Professional part | $48.98 | $66.07 | $114.82 |
United Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $53.70 Typical High $77.62 | Professional | TC · Technical part | $33.11 | $53.70 | $77.62 |
4 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 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Professional | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Where Maine sits
The same service costs 4.4 times more in Minnesota than in Alabama. 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· 27th of 51
$107
MN $275AL $63.10
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.