How much rates vary
Professionalmedian $1,122 · 10th to 90th $214 to $2,042
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 $1,096.48 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,096.48 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 26 · Professional part | $213.80 | $223.87 | $223.87 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | TC · Technical part | $891.25 | $891.25 | $891.25 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $158.49 Median $213.80 Typical High $1,513.56 | Professional | None (both parts) | $158.49 | $213.80 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $257.04 Typical High $380.19 | Professional | 26 · Professional part | $204.17 | $257.04 | $380.19 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $251.19 Median $1,122.02 Typical High $1,513.56 | Professional | TC · Technical part | $251.19 | $1,122.02 | $1,513.56 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,230.27 Median $1,380.38 Typical High $2,238.72 | Professional | None (both parts) | $1,230.27 | $1,380.38 | $2,238.72 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $281.84 Typical High $436.52 | Professional | 26 · Professional part | $239.88 | $281.84 | $436.52 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $1,000.00 Median $1,122.02 Typical High $1,778.28 | Professional | TC · Technical part | $1,000.00 | $1,122.02 | $1,778.28 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $1,318.26 Median $1,513.56 Typical High $2,454.71 | Professional | None (both parts) | $1,318.26 | $1,513.56 | $2,454.71 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $257.04 Median $302.00 Typical High $407.38 | Professional | 26 · Professional part | $257.04 | $302.00 | $407.38 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $1,047.13 Median $1,202.26 Typical High $2,187.76 | Professional | TC · Technical part | $1,047.13 | $1,202.26 | $2,187.76 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $1,122.02 Median $1,122.02 Typical High $1,122.02 | Professional | None (both parts) | $1,122.02 | $1,122.02 | $1,122.02 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $213.80 Median $223.87 Typical High $223.87 | Professional | 26 · Professional part | $213.80 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $891.25 Median $891.25 Typical High $891.25 | Professional | TC · Technical part | $891.25 | $891.25 | $891.25 |
United Setting Professional Modifier None (both parts) Typical Low $1,380.38 Median $1,737.80 Typical High $2,818.38 | Professional | None (both parts) | $1,380.38 | $1,737.80 | $2,818.38 |
United Setting Professional Modifier 26 · Professional part Typical Low $239.88 Median $316.23 Typical High $389.05 | Professional | 26 · Professional part | $239.88 | $316.23 | $389.05 |
United Setting Professional Modifier TC · Technical part Typical Low $1,122.02 Median $1,412.54 Typical High $2,454.71 | Professional | TC · Technical part | $1,122.02 | $1,412.54 | $2,454.71 |
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 $549.54 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $549.54 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $218.78 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $112.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $562.34 Median $562.34 Typical High $562.34 | Professional | 52 · Reduced service | $562.34 | $562.34 | $562.34 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 53 · Discontinued | $223.87 | $223.87 | $223.87 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $165.96 | $165.96 | $165.96 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | 56 · Pre-op care only | $112.20 | $112.20 | $112.20 |
Where Maine sits
The same service costs 11.2 times more in Alaska than in Kentucky. 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· 28th of 51
$1,122
AK $3,020KY $269
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.