How much rates vary
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 $72.44 Median $5,370.32 Typical High $7,943.28 | Facility | None | $72.44 | $5,370.32 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $70.79 Median $72.44 Typical High $72.44 | Professional | None (both parts) | $70.79 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 26 · Professional part | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | TC · Technical part | $41.69 | $45.71 | $45.71 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $58.88 Median $75.86 Typical High $151.36 | Professional | None (both parts) | $58.88 | $75.86 | $151.36 |
Anthem BCBS Setting Professional Modifier 26 · Professional part Typical Low $25.12 Median $28.18 Typical High $57.54 | Professional | 26 · Professional part | $25.12 | $28.18 | $57.54 |
Anthem BCBS Setting Professional Modifier TC · Technical part Typical Low $34.67 Median $46.77 Typical High $93.33 | Professional | TC · Technical part | $34.67 | $46.77 | $93.33 |
Kaiser Permanente Setting Professional Modifier None Typical Low $66.07 Median $79.43 Typical High $112.20 | Professional | None | $66.07 | $79.43 | $112.20 |
United Setting Professional Modifier None (both parts) Typical Low $66.07 Median $100.00 Typical High $223.87 | Professional | None (both parts) | $66.07 | $100.00 | $223.87 |
United Setting Professional Modifier 26 · Professional part Typical Low $25.70 Median $39.81 Typical High $85.11 | Professional | 26 · Professional part | $25.70 | $39.81 | $85.11 |
United Setting Professional Modifier TC · Technical part Typical Low $40.74 Median $60.26 Typical High $123.03 | Professional | TC · Technical part | $40.74 | $60.26 | $123.03 |
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 $34.67 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $34.67 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.13 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $54.95 Typical High $54.95 | Professional | 54 · Surgery only | $52.48 | $54.95 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.47 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.08 | $7.24 | $7.24 |
Where Georgia 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.
Georgia· 28th of 51
$75.86
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.