How much rates vary
Facilitymedian $115 · 10th to 90th $58 to $6,310Professionalmedian $110 · 10th to 90th $66 to $550
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 $66.07 Median $5,888.44 Typical High $7,943.28 | Facility | None | $66.07 | $5,888.44 | $7,943.28 |
Aetna Setting Professional Modifier None (both parts) Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None (both parts) | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $26.30 Median $26.30 Typical High $26.30 | Professional | 26 · Professional part | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | TC · Technical part | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None (both parts) Typical Low $89.13 Median $125.89 Typical High $125.89 | Professional | None (both parts) | $89.13 | $125.89 | $125.89 |
Hally Health Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $138.04 | Facility | None | $64.57 | $114.82 | $138.04 |
Medica Setting Professional Modifier None (both parts) Typical Low $83.18 Median $151.36 Typical High $549.54 | Professional | None (both parts) | $83.18 | $151.36 | $549.54 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $48.98 Median $107.15 Typical High $218.78 | Professional | 26 · Professional part | $48.98 | $107.15 | $218.78 |
Medica Setting Professional Modifier TC · Technical part Typical Low $31.62 Median $74.13 Typical High $331.13 | Professional | TC · Technical part | $31.62 | $74.13 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $154.88 | Professional | None | $89.13 | $89.13 | $154.88 |
United Setting Facility Modifier None Typical Low $56.23 Median $93.33 Typical High $117.49 | Facility | None | $56.23 | $93.33 | $117.49 |
United Setting Professional Modifier None (both parts) Typical Low $79.43 Median $109.65 Typical High $208.93 | Professional | None (both parts) | $79.43 | $109.65 | $208.93 |
United Setting Professional Modifier 26 · Professional part Typical Low $44.67 Median $66.07 Typical High $128.82 | Professional | 26 · Professional part | $44.67 | $66.07 | $128.82 |
United Setting Professional Modifier TC · Technical part Typical Low $30.20 Median $44.67 Typical High $79.43 | Professional | TC · Technical part | $30.20 | $44.67 | $79.43 |
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 $33.11 Median $33.11 Typical High $33.11 | Professional | 52 · Reduced service | $33.11 | $33.11 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $13.18 Typical High $13.18 | Professional | 53 · Discontinued | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | 54 · Surgery only | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.00 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.61 | $6.61 | $6.61 |
Where Iowa 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.
Iowa· 8th of 51
$110
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.