How much rates vary
Facilitymedian $2,089 · 10th to 90th $39 to $12,023Professionalmedian $66 · 10th to 90th $45 to $91
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 Facility Modifier None Typical Low $645.65 Median $4,786.30 Typical High $12,022.64 | Facility | None | $645.65 | $4,786.30 | $12,022.64 |
Aetna Setting Professional Modifier None (both parts) Typical Low $44.67 Median $74.13 Typical High $79.43 | Professional | None (both parts) | $44.67 | $74.13 | $79.43 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $17.38 Median $29.51 Typical High $30.20 | Professional | 26 · Professional part | $17.38 | $29.51 | $30.20 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $27.54 Median $45.71 Typical High $48.98 | Professional | TC · Technical part | $27.54 | $45.71 | $48.98 |
AvMed Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
AvMed Setting Professional Modifier None (both parts) Typical Low $27.54 Median $34.67 Typical High $38.02 | Professional | None (both parts) | $27.54 | $34.67 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $75.86 Typical High $125.89 | Facility | None | $67.61 | $75.86 | $125.89 |
Cigna Setting Professional Modifier None (both parts) Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None (both parts) | $354.81 | $354.81 | $354.81 |
Florida Blue Setting Facility Modifier None Typical Low $51.29 Median $53.70 Typical High $58.88 | Facility | None | $51.29 | $53.70 | $58.88 |
Florida Blue Setting Professional Modifier None (both parts) Typical Low $47.86 Median $66.07 Typical High $70.79 | Professional | None (both parts) | $47.86 | $66.07 | $70.79 |
Florida Blue Setting Professional Modifier 26 · Professional part Typical Low $21.88 Median $30.90 Typical High $32.36 | Professional | 26 · Professional part | $21.88 | $30.90 | $32.36 |
Florida Blue Setting Professional Modifier TC · Technical part Typical Low $25.70 Median $34.67 Typical High $38.02 | Professional | TC · Technical part | $25.70 | $34.67 | $38.02 |
Molina Setting Professional Modifier None (both parts) Typical Low $47.86 Median $50.12 Typical High $104.71 | Professional | None (both parts) | $47.86 | $50.12 | $104.71 |
United Setting Facility Modifier None Typical Low $43.65 Median $46.77 Typical High $46.77 | Facility | None | $43.65 | $46.77 | $46.77 |
United Setting Professional Modifier None (both parts) Typical Low $53.70 Median $72.44 Typical High $134.90 | Professional | None (both parts) | $53.70 | $72.44 | $134.90 |
United Setting Professional Modifier 26 · Professional part Typical Low $20.42 Median $27.54 Typical High $53.70 | Professional | 26 · Professional part | $20.42 | $27.54 | $53.70 |
United Setting Professional Modifier TC · Technical part Typical Low $33.11 Median $43.65 Typical High $83.18 | Professional | TC · Technical part | $33.11 | $43.65 | $83.18 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | None (both parts) | $58.88 | $58.88 | $66.07 |
Wellpoint Setting Professional Modifier 26 · Professional part Typical Low $30.90 Median $33.88 Typical High $33.88 | Professional | 26 · Professional part | $30.90 | $33.88 | $33.88 |
Wellpoint Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $44.67 Typical High $44.67 | Professional | TC · Technical part | $34.67 | $44.67 | $44.67 |
5 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 $22.39 Median $37.15 Typical High $39.81 | Professional | 52 · Reduced service | $22.39 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $14.79 Typical High $15.85 | Professional | 53 · Discontinued | $8.91 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $56.23 Typical High $58.88 | Professional | 54 · Surgery only | $33.88 | $56.23 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $6.76 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.41 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.47 | $7.41 | $7.94 |
Where Florida sits
The same service costs 4.4 times more in Texas than in New York. 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.
Florida· 43rd of 51
$66.07
TX $174NY $39.81
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.