How much rates vary
Professionalmedian $977 · 10th to 90th $186 to $1,622
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 $954.99 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $954.99 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 26 · Professional part | $186.21 | $194.98 | $194.98 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $758.58 Median $776.25 Typical High $776.25 | Professional | TC · Technical part | $758.58 | $776.25 | $776.25 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $138.04 Median $186.21 Typical High $1,318.26 | Professional | None (both parts) | $138.04 | $186.21 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $177.83 Median $218.78 Typical High $331.13 | Professional | 26 · Professional part | $177.83 | $218.78 | $331.13 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $213.80 Median $954.99 Typical High $1,202.26 | Professional | TC · Technical part | $213.80 | $954.99 | $1,202.26 |
Cigna Setting Professional Modifier None (both parts) Typical Low $1,047.13 Median $1,230.27 Typical High $1,905.46 | Professional | None (both parts) | $1,047.13 | $1,230.27 | $1,905.46 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $204.17 Median $245.47 Typical High $380.19 | Professional | 26 · Professional part | $204.17 | $245.47 | $380.19 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $851.14 Median $977.24 Typical High $1,548.82 | Professional | TC · Technical part | $851.14 | $977.24 | $1,548.82 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $758.58 Median $1,148.15 Typical High $1,778.28 | Professional | None (both parts) | $758.58 | $1,148.15 | $1,778.28 |
Harvard Pilgrim Setting Professional Modifier 26 · Professional part Typical Low $223.87 Median $263.03 Typical High $354.81 | Professional | 26 · Professional part | $223.87 | $263.03 | $354.81 |
Harvard Pilgrim Setting Professional Modifier TC · Technical part Typical Low $489.78 Median $912.01 Typical High $1,412.54 | Professional | TC · Technical part | $489.78 | $912.01 | $1,412.54 |
Martin's Point Setting Professional Modifier None (both parts) Typical Low $977.24 Median $977.24 Typical High $977.24 | Professional | None (both parts) | $977.24 | $977.24 | $977.24 |
Martin's Point Setting Professional Modifier 26 · Professional part Typical Low $186.21 Median $194.98 Typical High $194.98 | Professional | 26 · Professional part | $186.21 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier TC · Technical part Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | TC · Technical part | $776.25 | $776.25 | $776.25 |
United Setting Professional Modifier None (both parts) Typical Low $707.95 Median $912.01 Typical High $1,698.24 | Professional | None (both parts) | $707.95 | $912.01 | $1,698.24 |
United Setting Professional Modifier 26 · Professional part Typical Low $208.93 Median $275.42 Typical High $338.84 | Professional | 26 · Professional part | $208.93 | $275.42 | $338.84 |
United Setting Professional Modifier TC · Technical part Typical Low $457.09 Median $602.56 Typical High $1,348.96 | Professional | TC · Technical part | $457.09 | $602.56 | $1,348.96 |
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 $478.63 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $478.63 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $190.55 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $141.25 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $95.50 | $97.72 | $97.72 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 52 · Reduced service | $489.78 | $489.78 | $489.78 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | 53 · Discontinued | $194.98 | $194.98 | $194.98 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $147.91 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $97.72 |
Where Maine sits
The same service costs 9.1 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· 21st of 51
$977
AK $2,188KY $240
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.